CQC report explained · a residential care home
What the CQC found at Eastfield Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, staffing, recruitment, risk management and infection control were found to be safe.
- Effective?
- Good
- Care plans were detailed and person-centred. Staff were trained and supported, and people received appropriate help with nutrition, healthcare and decisions about their care.
- Caring?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The management had effective checks and audits, listened to feedback and analysed accidents and incidents. Inspectors found an open culture where people and staff could raise concerns.
What inspectors found, February 2023
Rated Good; inspectors found safe, effective and well-led care, with improvements since the last inspection.
This was an unannounced focused inspection on 13 and 17 January 2023. One inspector spoke with four people living at the home and staff, and reviewed care, medicines, recruitment and management records.
Inspectors found people were protected from abuse and avoidable harm. Medicines were managed safely, staffing levels met people's needs, infection controls were suitable, and care plans reflected people's needs and choices. Staff were trained and supported, and people received help with food, drinks and healthcare.
The home was rated Good overall, and Safe, Effective and Well-led were each rated Good. The previous rating was Requires Improvement in June 2021. Inspectors found the provider had made the required improvements and was no longer in breach of regulations.
Safe medicines
Medicines were managed safely, including medicines given only when needed. Staff training and checks supported safe administration.
“Guidance for staff to safely and consistently administer medicines prescribed PRN was in place.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment checks and induction helped ensure staff were suitable and prepared for their roles.
“Appropriate staffing levels were in place to meet the needs of people in the service.” from the report
Involvement in decisions
Where people lacked capacity, assessments and best-interest meetings were completed. These involved professionals and significant others.
“Assessments had been completed when people lacked capacity and best interest meetings were held, which included professionals and significant others.” from the report
Open management
The provider sought feedback from people and relatives and had an open culture. People and staff said they could approach the manager when needed.
“The provider and registered manager fostered an open and inclusive culture.” from the report
Policies did not fully support choice
needs fixingThe report says the policies and systems did not support people's maximum choice and control or the least restrictive approach. This was identified even though the Effective rating was Good.
“the policies and systems in the service did not support this.” from the report
- 01How do you make sure your policies support each person's maximum choice and use the least restrictive approach?
- 02How are medicines prescribed to be given only when needed recorded, reviewed and checked?
- 03How do you use staffing and dependency assessments to decide how many staff are needed each day?
- 04How are capacity assessments, best-interest decisions and any Deprivation of Liberty Safeguards applications kept up to date?
- 05How do you gather and act on feedback from people and relatives, including any concerns?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 1 February 2023 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, June 2021
Eastfield Residential Home is rated Requires Improvement; inspectors found a continued breach over consent and weaknesses in medicines records, staffing records and quality checks.
This was an unannounced follow-up inspection on 29 April 2021. Two inspectors spoke with people, relatives, managers and care staff. They reviewed care records, medicines records, staff files and management records.
The home had improved since the previous inspection. Risks were assessed more clearly, staffing levels met people's needs, safeguarding systems were working, infection control was satisfactory and the environment had been improved.
However, the home did not follow the Mental Capacity Act properly. Mental capacity assessments and best-interest decisions were not clearly recorded. Medicines guidance, staffing rotas and quality checks also needed improvement.
The overall rating remained Requires Improvement. Safe and Effective also remained Requires Improvement. Well-led improved from Inadequate to Requires Improvement. This inspection covered Safe, Effective and Well-led only, while other ratings carried over from the earlier comprehensive inspection.
Risk information improved
Care plans and risk assessments gave staff clearer guidance, including information about people's medical conditions.
“Risk assessments and care plans were detailed and provided guidance for staff to respond to, and manage risk effectively.” from the report
Staffing and recruitment
Inspectors found staffing levels met people's needs and recruitment was safe. New staff received an induction.
“Safe recruitment processes were in place.” from the report
Support with food and health
People were offered choices of food and drinks, with snacks available outside set times. Staff supported people to access healthcare and made referrals when needed.
“Peoples nutrition and hydration needs were effectively met.” from the report
PRN medicines guidance
needs fixingMedicines were generally managed safely, but instructions for medicines taken when needed were not always complete. The report recommended bringing these protocols in line with guidance.
“Guidance for staff to administer medicines prescribed 'as and when required' (PRN) were not always in place.” from the report
Staffing records
needs fixingStaffing levels met people's needs, but rotas did not always show agency use or arrangements for one-to-one support clearly.
“The staffing rota did not always clearly identify when agency staff had been used and also how staffing was arranged when people were funded for one to one support.” from the report
Quality checks
needs fixingA new monitoring system had been introduced, but it failed to identify some problems with Mental Capacity Act compliance and record keeping.
“Whilst we noted some areas of improvements within the service, there were some issues which the new quality monitoring system had not identified.” from the report
Training updates
minorSome staff refresher training was still overdue. The manager had a plan to address the gaps by the end of June 2021.
“However, gaps in refresher training continued to be identified.” from the report
- 01What has changed in the way you assess mental capacity and record best-interest decisions?
- 02How do you make sure decisions about a person's money reflect their wishes and use the least restrictive option?
- 03Have all PRN medicine protocols now been completed with clear instructions for staff?
- 04How do your current rotas record agency workers and one-to-one staffing arrangements?
- 05Has the planned refresher training been completed, and how are outstanding training gaps checked?
This was a planned follow-up inspection covering Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 30 June 2021 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 Eastfield Residential Home
6 rated inspections over 8 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- June 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- September 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- July 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 25 May 2011.
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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