CQC report explained · a residential care home
What the CQC found at Eastside House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2023
Eastside House was rated Requires Improvement; inspectors found kind, responsive care but ongoing risks and management weaknesses.
This was an unannounced comprehensive inspection. Inspectors visited on 24 November 2022, spoke with people, relatives, staff and professionals, observed care, and checked care records, staff files and management records.
There had been improvements in medicines, care planning and management. People and relatives said the home had improved. Staff were described as kind and caring, and people generally felt safe and well supported.
However, risk guidance was not always clear, including for mental health, diabetes and choking. Accident and incident reviews did not reliably identify lessons or make sure other health professionals were involved promptly. Mental capacity assessments were also incomplete.
The overall rating remains Requires Improvement, as do Safe, Effective and Well-led. Caring and Responsive were rated Good. The home has had this overall rating for the last three inspections.
Kind and respectful care
Inspectors saw staff being kind and people said they were treated with respect. Staff supported people's independence and understood their personal, cultural and religious needs.
“People were treated with care, kindness, and compassion, and supported to maximise their independence.” from the report
Personalised support
Care plans included people's backgrounds, health needs and preferences. Staff understood how people wanted their care provided and supported them to make choices.
“It was clear they understood people's needs, preferences and wishes, and worked hard to support them in personalised ways.” from the report
Improved medicines management
Medicines management had improved since the previous inspection. Staff had medicines training and their competence had been checked within the previous year.
“At this inspection we found improvements had been made, management of medicines was safe.” from the report
Risk information was incomplete
seriousStaff did not always have clear written guidance about important risks, including mental health, diabetes, choking and behaviours that could challenge. This left people at possible risk of harm.
“These risks to people were not always assessed and monitored and in the absence of documentation, placed people at risk of possible harm.” from the report
Accidents were not fully reviewed
seriousThe home recorded accidents and incidents but did not have a reliable system for checking patterns, updating risk assessments or making sure remedial action was taken promptly.
“It was not evident that lessons were learnt which were then shared across the staff team.” from the report
Mental capacity assessments incomplete
needs fixingNot all care records contained mental capacity assessments. Inspectors could not be fully confident that people always had maximum choice and control.
“We found that not all care records had mental capacity assessments.” from the report
Management checks missed problems
seriousAudits were completed, but management did not identify several issues found by inspectors. There was not enough independent checking or oversight of the quality of care.
“Management systems in place were not robust or sufficiently comprehensive to demonstrate adequate oversight of the quality of care at the home.” from the report
Long staff working hours
needs fixingSome staff rotas showed people working more than 80 hours a week. The home also lacked a system to monitor hours for staff with immigration service restrictions.
“Some rotas showed staff working in excess of 80 hours a week.” from the report
Limited food and activities
minorPeople had enough food and drinks, but several people said there was little choice and limited flexibility about when they could have snacks and drinks. Activities had improved but were still limited.
“People told us they would like more activities, especially in the winter.” from the report
- 01What written guidance is now in place for managing risks linked to mental health, diabetes, choking and behaviours that can challenge?
- 02How do you review accidents and incidents, identify patterns and make sure lessons are shared with all staff?
- 03Have mental capacity assessments now been completed for every person who needs one, and how are best-interest decisions recorded?
- 04How do you independently check your audits and make sure management identifies problems promptly?
- 05What has changed about menu choice, access to snacks and drinks, and activities, especially during winter?
This was an unannounced comprehensive inspection covering all five key questions, including infection prevention and control; the visit took place on 24 November 2022, with inspection activity continuing until 8 December 2022. This explanation was written from the published report of 5 January 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, November 2021
Eastside House was rated Requires Improvement; inspectors found kind staff but serious weaknesses in risk management, medicines, personalised care and management oversight.
This was an unannounced focused inspection on 07 July 2021 and 12 July 2021. Inspectors spoke with people, relatives, staff and professionals. They observed care and checked care, medicines, staff and management records.
People and relatives generally said they felt safe and that staff were kind and helpful. Staff were trained, there were enough staff on duty, and the home was clean. However, inspectors found significant concerns about care plans, risk assessments, medicines, accident reporting and meaningful activities.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe, Effective, Responsive and Well-led. Caring was not assessed in this inspection. The home had kept this rating since the previous inspection, and inspectors found that not enough improvement had been made.
Kind and supportive staff
People and relatives generally said staff were kind, caring and helpful. Inspectors also observed that staff knew people well.
“Most people reported that their carers were supportive and helpful to them and relatives told us that staff were kind and caring.” from the report
Staffing and training
Inspectors found enough staff on duty to meet people's basic needs safely. Staff had received training, supervision and appraisals.
“People received care and support from staff that were appropriately skilled and trained to carry out their role.” from the report
Clean and accessible home
The home appeared clean, with suitable infection control arrangements and accessible indoor and outdoor areas.
“The home appeared clean and records confirmed that appropriate cleaning arrangements were in place.” from the report
Improved consent processes
The provider had made enough improvement in consent and was no longer in breach of the relevant regulation. People were asked for verbal consent before staff supported them.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 11.” from the report
Incomplete risk information
seriousSome health risks were not fully assessed or included in care plans. This included risks linked to choking, pressure sores, falls and support at mealtimes.
“Risks to people were not always assessed, monitored and managed to keep them safe.” from the report
Medicines were not always safely managed
seriousMedicines records had gaps, medicine stocks did not always match the records, and some medicines were given without the required checks or advice. The home had not been carrying out regular medicines audits.
“The management of medicines was not safe. We found several areas where the service was not managing medicines safely in line with national guidance.” from the report
Too few activities and limited choice
needs fixingThe activity timetable was not followed and most people had little stimulation or conversation. Care plans did not properly record people's preferences and choices.
“During this inspection we found that these concerns had not been addressed.” from the report
Weak management oversight
seriousManagers were not carrying out checks in the areas where inspectors found problems. There was little evidence of learning, improvement or follow-up from earlier concerns.
“Management oversight of the service was ineffective and did not identify the issues we found on the inspection.” from the report
People were reluctant to complain
needs fixingMany people said they would not raise concerns directly with staff or managers and would rely on family or friends instead. The provider was asked to review how it received feedback.
“We were not assured that sufficient processes were in place to ensure that people could raise concerns freely.” from the report
- 01What changes have been made to ensure every person's risks, health conditions and specialist guidance are clearly recorded in their care plan?
- 02How are medicines now checked, including MAR records, medicine stocks, covert medicines and staff competency assessments?
- 03What regular activities are now available, and how are people's individual interests and choices recorded and followed?
- 04What audits and management checks are now completed to identify problems with care plans, medicines, accidents and incidents?
- 05How can residents raise concerns directly and privately, and what action is taken after feedback?
This was a focused inspection of Safe, Effective, Responsive and Well-led; the other ratings from the previous comprehensive inspection were carried over and Caring was not assessed on this occasion. This explanation was written from the published report of 4 November 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 Eastside House
4 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 15 April 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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