This inspection took place on 17 March 2015 and was unannounced. A second day of inspection was announced and took place on 18 March 2015. We last inspected the home on 02 December 2013 and found the provider was meeting all legal requirements inspected against.
Eothen Residential Home Gosforth provides care and support for up to 37 older people. At the time of the inspection there were 30 people using the service.
All rooms were ensuite and had direct dial land lines. Wi-Fi and computers were available throughout the home for people to use.
There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
On the two days of the inspection the registered manager was not present so we were supported by the Chief Executive and two care co-ordinators.
The provider was not meeting the regulations for record keeping. Evaluations of care plans were completed which gave an update on people’s needs. We found that changes in care needs did not routinely lead to a new care plan and risk assessment being completed. This means people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.
People and their relatives told us they felt safe living at the home. Staff understood how to safeguard people from abuse and knew how to report any concerns. There was a variety of posters and leaflets available and on display around the home which included safeguarding, whistle-blowing, advocacy and dignity.
Accidents and incidents were reported and recorded and information was analysed for any trends. Referrals to other healthcare professionals were made if needed, including contact the emergency services or doctors.
Health and safety risk assessments, checks and emergency plans were in place. Following a visit by the fire brigade personal evacuation plans were being developed. Staff knew what to do to evacuate should there be a fire and all staff had received training and taken part in fire drills.
There were enough staff to meet people’s needs. Staff did not rush people and spent time with them chatting and engaging as well as offering relevant support.
Appropriate recruitment procedures were in place. This included a formal interview process and a ‘meet and greet’ were interaction with people was observed. References and Disclosure and Barring Service (DBS) checks were completed before people were offered employment. The chief executive told us they were in the process of updating everyone’s DBS checks.
Medicines were stored and managed safely. Staff received competency based training from the pharmacy as well as from the provider. People and their doctor had signed documents titled ‘permission to administer homely medicines.’ This gave detail on specific over-the counter medicines which could be administered. The dose of the medicine and the frequency was recorded. Where people administered their own medicines checks were completed to ensure they were managing this safely.
People were cared for by staff who were trained and knowledgeable. Staff told us they could request additional specialist training if it was needed. Some staff had attended training in supporting people whose behaviour may challenge services.
Staff said they were well supported. We saw they had received regular supervision and an annual appraisal. New members of staff completed an induction period and attended a probation meeting to review their performance after they had been in post for three months.
Staff had a good understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). We observed staff seeking people’s consent before they were supported. They actively involved people in decision making on a day to day basis. Where necessary authorised Deprivation of Liberty Safeguards were in place and these were being managed appropriately.
People’s nutritional needs were being met. People told us the food was very good and we observed mealtimes to be a sociable and enjoyable experience for people. Where people had specific needs in relation to diet, appropriate professionals were involved such as dietitians or the speech and language therapy team.
People told us they were very well cared for and we saw warm and compassionate relationships between people and staff. Staff treated people with respect and were very aware of maintaining people’s dignity at all times. Staff clearly knew people well and were able to respond appropriately to any requests for support and interaction.
People were involved in their annual reviews, as were their relatives. This was an opportunity to review all aspects of the person’s life such as relationships, socialisation and interaction as well as the care they received.
Many of the activities and events on offer had been suggested by the people living at the home. There were two activities coordinators employed. People had been instrumental in maintaining contact with one of the activities coordinators who had moved to another Eothen home.
Everyone we spoke with knew how to complain but said they had no reason to.
People thought the home was well-led. We saw care coordinators worked alongside care staff and they were well known to people. The chief executive was present and was visibly supporting the staff team whilst the registered manager was off.
Surveys were completed annually and involved people, their relatives, staff and external stakeholders. Staff were complimentary about the managers and said they were easy to approach.
Regular staff meetings had been held and these were used for information sharing and sharing best practice as well as for ensuring tasks were actioned.
A variety of quality assurance audits were completed and generated action plans. Action plans were reviewed and any completed actions were signed off as such. The chief executive completed reviews which included seeking feedback from people and observing staff as well as reviewing documents. An external consultancy agency called Dementia Care Matters had also been employed to complete a review of the home and this was scheduled for the week after the inspection.
You can see what action we told the provider to take at the back of the full version of the report.