CQC report explained · a residential care home
What the CQC found at Eastbrook House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by risk assessments, safe medicines systems, recruitment checks and infection control procedures. Some staff said extra laundry and kitchen duties affected their workload and ability to care for people.
- Effective?
- Requires improvement
- People were not always offered a choice of meal at lunchtime. Fluid charts did not always show the required daily intake or total the amount drunk, although people were observed to be hydrated and had access to hot and cold drinks.
- Caring?
- Good
- People were treated with care, dignity and respect. Staff knew people well, involved them in day-to-day decisions and encouraged independence.
- Responsive?
- Good
- Care plans were detailed, personal and regularly reviewed. Activities were based on people's preferences, although listed activities did not always take place when the activity coordinator was absent.
- Well-led?
- Good
- Managers were visible and people, relatives and staff generally spoke positively about them. However, the home's own checks did not reliably identify or record problems with meal choices and fluid charts.
What inspectors found, October 2018
Rated Good overall; inspectors found safe, kind and personalised care, but meal choices and fluid records needed improvement.
This was an unannounced inspection on 21 and 22 August 2018. Inspectors observed care, spoke with people, relatives and staff, and checked care records, medicines, staff files, audits and policies.
The home was rated Good for being safe, caring, responsive and well-led. Medicines were administered safely, risks were assessed, staff treated people with dignity, and care plans were detailed and personal.
The home Requires Improvement for being effective. People were not consistently offered a choice of meals, especially at lunchtime. Fluid charts were incomplete and were not always used to identify when action might be needed. The overall Good rating means the service met the required standard overall, but important improvements were still needed.
Safe medicines
Inspectors found that medicines were given as prescribed and on time. Records, storage, controlled medicines and staff competency checks were generally in order.
“People received their medicines as prescribed and on time.” from the report
Kind and respectful care
People and relatives described staff as caring. Inspectors saw staff protecting privacy, dignity and confidentiality while encouraging independence.
“People and relatives confirmed that care staff were very caring and respectful.” from the report
Personalised care plans
Care plans recorded people's needs, wishes, histories and routines. Staff were able to use this information to provide personal care.
“Care plans were detailed, person centred and responsive to people's needs and wishes.” from the report
Safe care planning
Risks such as falls, choking, diabetes and skin damage were assessed, with guidance for staff on reducing those risks. Repositioning records had improved since the previous inspection.
“Risk assessments detailed the risk, how this affected the person and the steps staff should take to reduce or mitigate the known risks” from the report
Access to drinks
Although fluid records were incomplete, inspectors saw that people had access to drinks and snacks and found people were appropriately hydrated.
“However, we did note that people were appropriately hydrated and always had access to a variety of hot and cold drinks.” from the report
Limited meal choice
needs fixingAt lunchtime, people were generally given meals without being asked what they wanted. Visual menus were not available, which was a particular concern for people living with dementia.
“During lunchtime, on both days of the inspection, we observed that people were not offered a choice and meals were served from the kitchen and given to people without any sort of involvement from the person.” from the report
Incomplete fluid records
needs fixingFluid charts did not record recommended daily amounts or total what people had drunk. This made it harder to spot poor intake and take action.
“Fluid charts were not totalled at the end of the day to confirm what the person's fluid intake had been, to enable staff to monitor and take action where poor fluid intake had been noted.” from the report
Weak quality checks
needs fixingThe home knew about some meal problems, but had not formally recorded them or created an action plan. Its checks had not identified the fluid-recording problems.
“The provider did not robustly follow their own governance systems as the inspection process highlighted issues that the service should have identified and addressed themselves.” from the report
Extra duties for care staff
minorSome care staff said they had to take on laundry and kitchen duties when other staff were absent. They felt this affected their workload and ability to provide care.
“We are expected to do the laundry once the laundry staff leave and we are expected to do supper as there are no kitchen staff.” from the report
- 01How are residents now offered a genuine choice of meals at lunchtime, including visual choices for people living with dementia?
- 02How do you record each person's recommended fluid intake and check the daily total?
- 03What action do staff take when a person drinks less than the amount recommended for them?
- 04How do you check that meal quality and presentation are consistent between different cooks?
- 05How are concerns about extra laundry and kitchen duties affecting care staff being addressed?
This was an unannounced inspection covering all five key questions and the overall quality of the home; the registered manager was away on annual leave during the visit. This explanation was written from the published report of 17 October 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2016
Rated Good overall, but inspectors found unsafe medicines management and rated the home Requires Improvement for safety.
Inspectors visited without notice on 27 and 28 September 2016. They observed care, spoke with people, relatives, staff and health professionals, and reviewed care plans, staff files, training records, audits and other records.
People were generally treated kindly and with respect. Care plans were detailed and personalised. Staff were trained and supported, people had access to health professionals, and activities and complaints arrangements were in place.
The main problems were safety and record keeping. Medicines were not always recorded correctly, and two people missed prescribed medicines for several days. Food and fluid records and repositioning records were also incomplete.
The overall rating was Good. This means the home met the required standard in most areas, but its safety rating was Requires Improvement and the home breached Regulation 12.
Kind and respectful care
Inspectors saw warm and positive interactions. People were treated with dignity and their privacy was respected.
“The atmosphere within the home was warm and relaxed.” from the report
Personalised care plans
The care plans reviewed were specific to each person. They included needs, risks, preferences, life history and guidance for staff.
“We reviewed six care plans and found that care plans were person centred and reflective of the needs and requirements of each person living at the home.” from the report
Staff support and training
Staff had training, regular supervision and annual appraisals. Staff said managers were available and supportive.
“Care staff told us that they felt well supported by the registered manager and the senior management team in carrying out their roles effectively.” from the report
Good support with rights and decisions
The home had completed mental capacity assessments and submitted authorisation requests where people were deprived of their liberty.
“During this inspection we found that the service was meeting the requirements of the MCA and the Deprivation of Liberty Safeguards.” from the report
Activities and family involvement
There was a varied weekly activities programme. People and relatives were involved in care planning and reviews.
“A variety of activities were scheduled on each day of the week including bingo, keep fit, a visiting hairdresser and music therapy.” from the report
Medicines were missed or not recorded
seriousMedicine administration records had around ten gaps for nine people. Two people did not receive particular medicines for seven and ten days, and the home could not always confirm what had been given.
“We saw approximately ten different gaps on the MAR throughout the month of September 2016 for nine different people.” from the report
Repositioning and fluid records were incomplete
seriousRecords did not show that one person was repositioned as often as district nurses advised. Fluid charts were not detailed or totalled, making it harder to identify poor intake.
“The person was potentially being placed at risk of sustaining a pressure sore due to not being re-positioned appropriately as per guidance from the district nurses.” from the report
Weak follow-up after audits
needs fixingThe home identified some of the same problems as inspectors, but did not record what it had done or create improvement plans to prevent them happening again.
“However, the registered manager did not compile any action plans confirming what action had been taken once an issue had been identified.” from the report
People were not offered meal choices
minorAlthough alternatives were available on request, people, especially those living with dementia, were not offered a choice at the meal observed.
“However, on the day of the inspection and at the time of the meal, we observed that people were not given a choice of what they would like to eat” from the report
- 01How do you now check that every medicine has been given and that the Medicine Administration Record is signed?
- 02What safeguards are in place to prevent a person missing a prescribed medicine for several days?
- 03How do you monitor food and fluid intake, and when would you contact a health professional?
- 04How do you make sure people at risk of pressure sores are repositioned as advised, and how are these checks recorded?
- 05What written improvement plan followed the problems identified in the CQC report, and what evidence can you show that the changes are working?
This was an unannounced inspection covering all five rated questions and the overall quality of the home; the report also refers to a previous focused inspection in August 2015 checking medicines management. This explanation was written from the published report of 8 November 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Eastbrook House
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- October 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Inspected but not ratedSafe: Good
- July 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- December 2010
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 24 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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