CQC report explained · a residential care home
What the CQC found at Eckling Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found enough staff, safe recruitment, suitable risk plans, secure medicines and a clean, safe environment.
- Effective?
- Good
- Staff were trained and supported, and people's health and nutrition were managed well. Staff sought consent and followed the Mental Capacity Act principles.
- Caring?
- Good
- People described staff as kind and respectful. Inspectors saw warm interactions, support for privacy and dignity, and involvement in decisions about care.
- Responsive?
- Good
- Care plans included people's needs, preferences and communication requirements. The home provided activities, outings and support to reduce loneliness, and handled complaints in line with its procedure.
- Well-led?
- Good
- Inspectors found clear management arrangements, good communication and effective checks on quality and risks. The management team used incidents, audits and feedback to improve care.
What inspectors found, March 2019
Rated Good in all five areas; inspectors found safe, kind and person-centred care, with improvements since the previous inspection.
Inspectors visited without notice on 22 January 2019. Four inspectors, including a medicines specialist and an expert by experience, spoke with people, relatives and staff. They observed care and checked care, staffing, medicines and management records.
The inspectors found enough staff, safe medicines systems and a clean, well-maintained environment. Staff had suitable training and supported people's health, choices, dignity and independence. Care plans reflected people's needs and preferences, and people could take part in activities and community life.
The home had improved since the previous inspection in November 2017, when it was rated Requires improvement and had breached two regulations. At this inspection, all five key questions were rated Good. This means the inspectors found the legal requirements were met and that people's outcomes were consistently good.
Improved safety
The home had acted on concerns from the previous inspection. Medicines, risk management, staffing and the environment were found to be safe at this visit.
“Improvements had been made to the service following our previous inspection in November 2017 to address concerns and breaches of Regulations of the Health and Social Care Act 2008.” from the report
Kind and respectful staff
People had positive relationships with staff. Inspectors saw staff treating people warmly, respectfully and with attention to their privacy and dignity.
“People told us staff were very kind and treated them with respect.” from the report
Personalised care
Staff knew people's histories, preferences and support needs. Care plans were detailed and were updated when people's needs changed.
“Care plans highlighted individual needs and preferences and included detailed person-centred information.” from the report
Activities and community links
People could join activities, outings, religious services and links with local schools. The home also offered individual support for people who did not want group activities.
“The service provided an extensive range of enrichment activities and outings.” from the report
Strong management
The management team was described as approachable and visible. Quality checks, incident reviews and feedback were used to make improvements.
“The management team positively encouraged feedback, reviewed the quality of the service and acted on any identified shortfalls to continuously improve the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you use the staffing tool to decide how many staff are needed for my relative's needs?
- 02How are medicines checked through audits, and how do you record any changes made by prescribers?
- 03How would you support my relative's communication, mobility or dementia needs, including the use of the home's adapted environment?
- 04What activities and one-to-one options would be available if my relative did not want to join group activities?
- 05How would you record and follow my relative's wishes about end of life care and spiritual or religious support?
This was an unannounced comprehensive inspection covering the care home, the care provided, and the small domiciliary care service on the same site; all five ratings were assessed. This explanation was written from the published report of 2 March 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.
What inspectors found, December 2017
Requires Improvement; inspectors found kind, person-centred care, but medicines and quality checks were not consistently safe.
Inspectors visited on 1 and 2 November 2017. The first visit was unannounced. They spoke with people living in the home, relatives and staff, observed care, and checked care records, medicine records, recruitment files and safety records.
The home was rated Good for Effective, Caring and Responsive. Staff were described as kind and respectful. People had choices about their care, received enough food and drink, and were supported with their health, interests and religious needs.
Safe and Well-led were rated Requires Improvement. Inspectors found problems with medicine storage and records. Quality checks had not found or corrected these issues. Some important incidents had also not been reported to the CQC as required.
The overall rating remained Requires Improvement, as it had been at the previous inspection in July 2016. The report says some earlier improvements had been made but had not been sustained across the whole home.
Kind and respectful care
People told inspectors that staff were kind and treated them with dignity. Inspectors observed warm, compassionate relationships.
“Staff were kind, caring and compassionate. They put people first and valued them as individuals.” from the report
Personalised support
Care records reflected people's preferences and staff followed them. This included personal care, food, clothing and communication.
“People's individual needs and how they wanted their care delivered to them had been recorded within their care record.” from the report
Choice and independence
People were offered choices about meals, activities and daily care. Staff encouraged people to do as much as they could for themselves.
“People were offered as much freedom, choice and control to live their lives as they wished.” from the report
Training and healthcare
Staff had training and supervision, and people were supported to access health professionals when needed.
“Staff had received sufficient training and supervision to provide people with effective care.” from the report
Activities and community links
People could take part in hobbies, trips, spiritual activities and community events. The home supported links between residents and people living in the bungalows.
“There was a strong feeling of community within the home where people living in the home and in the bungalows developed friendships.” from the report
Medicine safety
seriousInspectors found missing or incorrect medicine records, unsecured creams and other storage problems. These issues created a risk of missed doses, double doses or overdose.
“People's medicines were not always managed safely.” from the report
Weak quality checks
seriousAudits had not identified repeated medicine-record problems, call-bell delays or the risk from hot exposed pipework. This meant the home did not consistently learn from earlier problems.
“Robust quality assurance systems were not all in place to ensure that issues and errors could be quickly identified and corrected.” from the report
Delayed call-bell responses
needs fixingThe home had improved the proportion of calls answered within five minutes, from 69% to 75%, but inspectors said further improvement was needed.
“This meant that 25% of calls may not have been answered within this timeframe.” from the report
Incidents not reported
seriousThe provider had not always notified the CQC about important incidents, including one involving a person leaving the home when it was unsafe.
“The provider had not ensured we were being notified about important incidents as is required by law.” from the report
Hot exposed pipework
seriousHot pipework in a communal bathroom created a possible burn risk for people who might fall against it. The provider acted immediately after inspectors raised this.
“Some pipework in a communal bathroom was very hot which posed a risk of burns to people if they fell against them or touched them.” from the report
- 01What changes have been made to medicine storage, administration and record checks since the inspection?
- 02How do you now make sure staff know who must record insulin when it is given jointly with community nurses?
- 03What are the current call-bell response times, and how are delays investigated?
- 04How do you make sure all incidents that must be reported are notified to the CQC promptly?
- 05How do your current audits show that improvements are being sustained across the whole home?
This was a comprehensive inspection covering all five key questions, with detailed checks of medicines, care records, staffing, recruitment, training and the premises. This explanation was written from the published report of 12 December 2017 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Eckling Grange
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 January 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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13 live-in carers within about an hour of Norfolk
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 £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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.