CQC report explained · a residential care home
What the CQC found at Eco Nights
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2022
Requires Improvement; inspectors found risks around restraint, staff training, infection control and service oversight.
This was an announced inspection carried out over four visits in July 2022. The inspector visited during the day and out of hours, spoke with people, relatives and staff, and reviewed care, medicines, recruitment, training and management records.
The home provided kind and suitable care, and people had care plans, risk assessments and support to communicate in their own ways. Relatives said people were safe and that communication with managers was good. The home was clean, had enough staff at the time, and supported people to use the community.
However, the inspectors found important weaknesses. Records did not show clearly that restraint was used only as a last resort or what had been learned from incidents. Hazardous substances were not always secure, some staff training and inductions were incomplete, infection control practice was not always up to date, and quality checks had not found these problems.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. Both ratings had fallen from Good at the previous inspection, published in October 2019. The report says the provider must send an action plan and that CQC will continue to monitor the home.
Kind, suitable care
Inspectors found that people's care was kind and met their needs. Care plans reflected people's needs and risks were recorded.
“People's care and support plans reflected their range of needs. Risks to people were assessed and recorded.” from the report
Clean premises
The respite service was reported to be clean and free from odours. There were sufficient supplies of PPE.
“The respite service was clean and odour free.” from the report
Medicines records
The three medication records reviewed were in good order and showed medicines were given as prescribed.
“Medication Administration Records [MAR] were viewed for three people. These were in good order, provided an account of medicines used and demonstrated people were given their medicines as specified by the prescriber.” from the report
Restraint records and safeguards
seriousThe home recorded when restraint was used, but records did not clearly show what staff tried first or what had been learned. Inspectors could not be assured that people were protected from unlawful restraint.
“We could not be assured that appropriate arrangements were in place to protect people from unlawful restraint.” from the report
Hazardous substances
seriousCOSHH items were not always stored securely. On one visit, laundry-room keys were left in the lock while hazardous items were inside.
“On the second out of hours visit to Eco Nights, the keys to the laundry room were left in the lock.” from the report
Agency staff knowledge
needs fixingAn agency worker did not know the names of two people and had not read all available profiles. This could affect personalised support.
“The agency member of staff on duty did not know the names of two people using the service and referred to one person by their wrong name and gender.” from the report
Training and induction
needs fixingSome staff training was out of date or missing, including safeguarding, infection control and specialist training. There was no evidence of induction for 10 of 12 agency staff used at the home.
“No evidence of induction was available for 10 out of 12 agency staff used at the service.” from the report
Infection control practice
needs fixingThe home was not always following current COVID-19 guidance. Staff did not always use PPE safely, and some required infection-control training was incomplete.
“Not all staff were using Personal Protective Equipment [PPE] effectively and safely.” from the report
Quality checks
needs fixingManagement audits had missed several risks and did not consistently identify trends or lessons from incidents. Inspectors said oversight required improvement.
“The provider had failed to identify the areas for improvement found as part of this inspection.” from the report
- 01What has changed to show that restraint is used only as a last resort, and how are incidents reviewed for lessons?
- 02How are hazardous substances kept locked and checked during every shift?
- 03How do you make sure agency staff read each person's profile and know their communication needs before providing care?
- 04How do you check that all permanent and agency staff have current safeguarding, infection-control, first-aid and specialist training?
- 05What action has been taken to improve audits, incident reporting and management oversight since this inspection?
This inspection focused on Safe and Well-led; the report did not give separate ratings for Effective, Caring or Responsive, and Safe and Well-led had fallen from Good at the previous inspection. This explanation was written from the published report of 6 September 2022 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, October 2019
Rated Good overall, with Outstanding caring; inspectors found personalised, compassionate support and some minor staffing and record-keeping issues.
This was a planned inspection of the home. One inspector reviewed information, spoke with relatives, staff and managers, observed people using the service, and checked care, recruitment and quality records.
The home supported younger adults with complex needs during respite stays. Inspectors found people were safe, had their health and nutritional needs met, and received personalised support. Medicines were managed safely and staff worked with families and health professionals.
Caring was rated Outstanding. Inspectors saw kind and respectful relationships, strong communication with relatives, and support that promoted choice, independence and inclusion. Safe, Effective, Responsive and Well-led were each rated Good.
The overall Good rating means the home was meeting the relevant standards and providing good care. Caring had improved from Good to Outstanding since the previous inspection in 2016. Inspectors noted that more staff were being recruited and that some management oversight and care-record entries needed to be recorded more consistently.
Exceptionally caring staff
Inspectors found strong, compassionate relationships. Staff treated people as individuals and supported them with patience, dignity and respect.
“people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.” from the report
Personalised support
Care plans described people's likes, dislikes, communication methods and support needs in detail. Relatives were involved in planning and reviewing care.
“People received personalised care which met their needs and preferences.” from the report
Good family communication
Staff kept relatives informed about incidents, health concerns and daily activities. Relatives said they trusted staff and felt listened to.
“Excellent communication between people, staff and relatives facilitated safe care and effective support.” from the report
Safe medicines and risk management
Medicines records were in good order, staff were trained and checked before administering medicines alone, and risks were regularly reviewed.
“Peoples medicines were managed safely.” from the report
Staffing during challenging situations
needs fixingStaff generally felt there were enough staff, but said extra staff would sometimes help when behaviours were challenging. The home was recruiting more staff.
“Staff consistently told us that generally there were enough staff, however some behaviours could be challenging at times and more staff to support each other and other people would be beneficial.” from the report
Consistency of care records
minorThe manager had identified that staff entries in care records were not always uniform and planned to address this at a staff meeting.
“they had identified the need for more uniformity with regard to staff's entries in people's care records” from the report
Formal management records
minorManagement communication and oversight were good, but the registered manager agreed that this oversight needed to be recorded officially.
“the registered manager agreed that their oversight needed to be recorded officially.” from the report
- 01How many staff will normally support my relative during a respite stay, especially if their behaviour becomes challenging?
- 02What progress has been made with recruiting additional staff since this inspection?
- 03How do you make sure staff record care consistently and accurately?
- 04How is management oversight of the home now recorded formally?
- 05How will you support my relative's communication, choices, independence and preferred activities?
This was a planned inspection covering all five CQC questions, with both the care provided and the premises looked at; the previous overall rating was Good in 2016. This explanation was written from the published report of 22 October 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 Eco Nights
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Requires improvement
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- May 2012
Registered with the Care Quality Commission on 30 May 2012.
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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Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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