CQC report explained · a nursing home
What the CQC found at Eshcol House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from abuse and avoidable harm. Infection control, risk management, staffing, medicines and equipment checks were all found to be suitable.
- Effective?
- Good
- This question was not rated in this focused inspection.
- Caring?
- Good
- This question was not rated in this focused inspection, although inspectors reported compassionate care and positive feedback from people, relatives and professionals.
- Responsive?
- Good
- This question was not rated in this focused inspection.
- Well-led?
- Good
- Inspectors found effective quality checks, a positive culture and clear roles between the manager and provider's director. They also noted recent management changes and that there was no registered manager in post.
What inspectors found, February 2023
Rated Good; inspectors found safe, kind care and stronger management, but there was no registered manager in post.
This was an unannounced, focused inspection. The inspector visited on 20 December 2022 and reviewed care, medicine and staff records, audits, infection control and feedback from people, relatives and health professionals.
The home was rated Good for Safe and Well-led. Inspectors found suitable infection control, enough staff, safe medicines, well-managed risks and appropriate safeguarding arrangements. People were supported with patience and compassion, and feedback about the care was positive.
The home had previously been rated Requires improvement, with a breach of regulations. Inspectors found that improvements had been made and that the home was no longer in breach. There had been management changes, and there was no registered manager in post at the time of this inspection.
Infection control
The home was following current infection control guidance. It was clean, high-contact areas were cleaned regularly and staff used protective equipment safely.
“At this inspection we found the service was following current infection control guidance and was no longer in breach of this regulation.” from the report
Safe staffing
Inspectors found enough staff to meet people's needs. Staff recruitment checks had also been completed safely.
“The service employed enough staff to meet people's care and support needs.” from the report
Kind and patient care
Staff supported people at a relaxed pace and took time to help them remain as independent as possible. Mealtimes were handled with particular patience.
“The food served was tasty and freshly prepared and staff were exceptionally patient and supportive while encouraging people to eat well.” from the report
Quality improvement
The provider had added a quality assurance role and was using audits to identify and address problems. Complaints were treated as opportunities to learn.
“Quality assurance systems were robust and an additional staff member had been recruited with specific quality assurance and auditing responsibilities since our last inspection.” from the report
Positive culture
Relatives and staff described the culture positively. Inspectors saw people who were comfortable asking staff for help.
“Staff were well motivated and focused on meeting people's needs.” from the report
No registered manager
needs fixingThere was no registered manager in post during the inspection. The returning manager intended to reapply for the role, so you should ask about progress and interim oversight.
“However, the manager, who had previously been a registered manager for this service, intended to reapply for this role.” from the report
Recent management changes
needs fixingThe report says management turnover affected the consistency and quality of leadership. The previous registered manager had returned to the service by the inspection.
“There had been a further management change, and this had impacted on the consistency and quality of leadership the staff team had received.” from the report
- 01When will the manager reapply to become the home's registered manager, and who is responsible for oversight until then?
- 02What steps have been taken to prevent further management changes affecting leadership consistency?
- 03How are audits of care records and medicines followed up when they identify a problem?
- 04How will the building work and new bedrooms affect people living in the home?
- 05How will you make sure staffing levels remain sufficient, including for nursing shifts?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key questions were not rated in this report. This explanation was written from the published report of 17 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, March 2021
Requires Improvement; inspectors found unsafe infection control practices at first, although care planning and activities were good.
This was a focused inspection on 20 and 23 October 2020. Inspectors responded to concerns about staff not following infection control guidance during the Covid-19 pandemic. They spoke with people, staff, relatives and health professionals, observed care and reviewed care, medicine, incident and staff records.
The home was clean and medicines were managed safely. Care plans were accurate and updated when people's needs changed. People were supported with activities, visits and communication, and complaints were investigated.
At the start of the inspection, some staff were not wearing the correct surgical masks. Social distancing was also not followed during staff breaks. The home acted immediately after inspectors raised this, but the failure exposed people to a risk of harm and led to a breach of Regulation 12.
The overall rating was Requires Improvement. Safe and well-led were rated Requires Improvement, while responsive was rated Good. The report did not give ratings for Effective or Caring because this was a focused inspection.
Updated care plans
Care plans were promptly updated when people's needs changed. They included personal history, interests, hobbies and medical information.
“People's care plans had been promptly updated when changes in their individual needs were identified.” from the report
Activities and relationships
People were offered individual activities such as games, arts and crafts and singing. The home also supported visits and community access.
“During our inspection people enjoyed participating in a variety of activities on a one to one basis including games, arts and crafts and sing-a-longs.” from the report
Medicines management
Inspectors found that medicines were stored, given and recorded safely. Records were regularly checked.
“Medicines were managed, stored and administrated safely.” from the report
Clean environment
The home was clean and had extra cleaning arrangements and handwashing facilities. It had also made arrangements for safer relative visits.
“The service was clean and there were effective cleaning procedures in place.” from the report
Infection control was not consistent
seriousWhen inspectors arrived, a care worker was wearing a cloth face covering instead of the correct surgical mask. Administrative staff were not wearing masks and social distancing was not respected during breaks.
“These failures to follow current infection control guidance exposed people to risk of harm and was a breach of the requirements of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Quality checks were being updated
needs fixingThe home's quality assurance systems were not fully established. Auditing procedures for care plans were still being updated.
“Auditing procedures for care plans were in the process of being updated to ensure the maximum benefits were gained from use of the digital care planning system.” from the report
- 01How do you now check that every member of staff wears the correct surgical mask when required?
- 02What do the PPE champions do, and how often are their checks recorded?
- 03What evidence can you show that staff follow social distancing rules during breaks?
- 04How have the updated auditing processes changed since this inspection?
- 05How will you tell families if infection control problems are found again?
This was a focused inspection of Safe, Responsive and Well-led, with particular attention to infection prevention and control; Effective and Caring were not rated. This explanation was written from the published report of 11 March 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 Eshcol House Nursing Home
6 rated inspections over 7 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- October 2018Goodup from Requires improvementSafe: GoodResponsive: Requires improvementWell-led: Good
- September 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2017Goodstayed GoodWell-led: Requires improvement
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 24 October 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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10 live-in carers within about two hours of Cornwall
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Most charge £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
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