CQC report explained · a residential care home
What the CQC found at Eastry House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People's risks were identified and staff had guidance to manage them. However, accident and incident analysis was incomplete and infection control arrangements were not consistently safe.
- Effective?
- Requires improvement
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Caring?
- Requires improvement
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Requires improvement
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- Provider oversight and quality auditing were not strong enough to identify and address shortfalls. The new registered manager had started an improvement plan and staff described a positive impact.
What inspectors found, April 2021
Eastry House is rated Requires Improvement; inspectors found kind care but weak infection control and management checks.
This was an unannounced focused inspection on 03 March 2021. Inspectors looked only at Safe and Well-led, including infection control. They spoke with five people and seven staff, and checked care, medicine, recruitment and management records.
People said they were happy, felt safe and were treated kindly. Inspectors found enough staff, suitable risk guidance, safe medicine systems and good relationships between people and staff. However, the building was difficult to clean, infection control practices were not always followed, and some medicine guidance was not personalised.
The home had not checked accidents and incidents thoroughly. Provider audits were not robust and had not identified important shortfalls. The overall rating remains Requires Improvement, as it was at the previous inspection, and this is the second consecutive inspection with that rating.
Kind relationships
People were happy with the care and spoke positively about staff and the manager. Inspectors saw a relaxed and comfortable atmosphere.
“People were very happy living at Eastry House and spoke highly of the registered manager and staff.” from the report
Staffing
People and staff said there were enough staff. Inspectors saw staff respond promptly and support people at mealtimes.
“People were cared for by a sufficient number of staff.” from the report
Risk support
People's individual risks were identified, with guidance for staff. Inspectors saw safe support with mobility and hoisting.
“People's mobility aids were left within their reach to reduce the risk of falls.” from the report
Involvement
People and staff said they were listened to and involved in decisions about the service.
“People and staff told us they felt involved in the running of the service.” from the report
Infection control
seriousSome areas were in poor condition and difficult to clean. Inspectors also saw PPE guidance not being followed and visitor checks were not thorough.
“The lack of robust recording of accidents and incidents and poor infection control systems is a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Incomplete incident monitoring
needs fixingThree recorded incidents were missing from the monthly analysis. This meant possible patterns or repeated risks could be missed.
“We read three incidents which were recorded, but not included in the monthly analysis for January 2021, meaning trends or themes of incidents could go unnoticed.” from the report
Weak provider oversight
seriousProvider audits had not identified the untidy medicines room or incomplete incident analysis. A recent provider quality audit could not be evidenced.
“The lack of robust management oversight by the registered provider was a continued breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2008.” from the report
PRN medicine guidance
needs fixingSome as-needed medicines did not have personalised guidance explaining how people might show they needed them. The manager later provided appropriate protocols.
“These lacked personalised information for people, they were able to provide us with evidence of appropriate PRN protocols following our inspection.” from the report
- 01What action has been taken to improve cleaning, repair worn surfaces and keep the medicines room suitable?
- 02How are accidents, incidents and near misses now analysed so that patterns are identified?
- 03How are staff checked to make sure they follow PPE and other infection control guidance?
- 04How are personalised protocols for as-needed medicines kept up to date and audited?
- 05What evidence can you show of the provider's regular quality audits and improvement plan?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 7 April 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.
What inspectors found, September 2019
Rated Requires Improvement; inspectors found kind and supportive care in places, but important safety, care planning and management problems remained.
This was an unannounced inspection on 18 July 2019. One inspector spoke with four people and five staff, and reviewed care records, medicines records, staff files and management records. The inspection covered the care provided and the home itself.
People generally said they felt safe and supported. Staff usually treated people with kindness and knew them well. There was enough staff on duty, people were supported with food, drink and healthcare, and many people took part in activities and local community life.
However, care plans did not always contain enough information about health risks such as diabetes, epilepsy and moving safely. Medicines records for creams and ointments were incomplete. Some areas and equipment needed cleaning or replacement. People were not always supported to make choices, be independent or follow their personal interests.
The overall rating and all five question ratings were Requires Improvement. The home had been rated Good at the previous inspection, published in January 2017. Inspectors found breaches of the rules about person-centred care and good governance.
Staff knew people well
Most staff had worked at the home for a long time. Inspectors saw positive relationships and staff responding with reassurance when people were anxious.
“People had built very strong relationships with staff, most of whom had worked at the service for a long period of time, and understood people's needs and preferences well.” from the report
Healthcare support
Staff involved healthcare professionals when people's needs changed. People had health action plans and pictorial hospital passports to help share important information.
“When people's needs changed, or they became unwell, staff liaised with the relevant healthcare professionals to ensure the person's needs were met.” from the report
Community activities
People were supported to go on trips, attend local activities and use community facilities. Visitors and befrienders could also maintain relationships with people.
“People were supported to be part of the local community, visiting hair salons for example.” from the report
Incomplete risk guidance
seriousCare plans did not give staff enough detail about managing diabetes, epilepsy, moving and handling, and other health needs. This was especially concerning because agency and newer staff were being used.
“The lack of detailed guidelines for staff to follow placed people at risk of not receiving the appropriate care and treatment.” from the report
Person-centred care was inconsistent
seriousCare plans were not always up to date or focused on people's goals and preferences. One person had not been supported to visit a place of worship that was important to them.
“The failure to provide person-centred care, designed to meet people's needs is a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) 2014.” from the report
Management checks were not effective
seriousQuality checks had not identified or dealt with problems such as missing window restrictors, incomplete care plans, medicine recording issues and gaps in recruitment checks.
“The failure to assess, monitor and mitigate risks to the quality of the service is a breach of Regulation 17 of the Health & Social care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Cleaning and maintenance
needs fixingSome furniture and equipment needed deep cleaning, repair or replacement. Communal areas and parts of the outside of the building also needed improvement.
“Areas of the service were in need of deep cleaning.” from the report
- 01How have you updated care plans so staff have clear instructions for diabetes, epilepsy, moving and handling, and other health risks?
- 02How do you check that creams and ointments are dated and that medicine records are completed on every shift?
- 03What has been done to clean, repair or replace the chairs, shower chairs, commodes and other equipment mentioned in the report?
- 04How do you support each person to work towards their own goals, maintain independence and follow their faith or personal interests?
- 05What checks are now in place to make sure staff recruitment records are complete before staff start work?
This was an unannounced inspection covering all five CQC questions; all five ratings had fallen from Good at the previous inspection. This explanation was written from the published report of 10 September 2019 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 Eastry House
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- April 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.