About the serviceEastfield Residential Home is a care home providing accommodation and personal care for up to 25 people with a mental health condition. At the time of our inspection 23 people lived at the service.
People’s experience of using this service
Records were not up to date and checks in place to monitor the quality of care being provided had not identified or addressed the concerns found. Improvements had not been made since the last inspection in relation to governance and oversight.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Risks to people were not always identified and managed. One area of the recruitment process required improvement to ensure safe and robust recruitment of new staff. Medicines practices were still not robust.
Staffing levels were low, and the service struggled to maintain a stable staff team. Staff did not feel valued or that their opinion mattered. Staff had not been supported in their roles and there were no records to demonstrate discussions regarding changes in institutionalised practices or culture since our last inspection. We found institutionalised practices were still in place.
There was a notifiable incident that happened at the service that should have been notified to Care Quality Commission (CQC) but this had not been done.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 2 April 2020). There were six breaches in regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
We undertook this focused inspection to check whether the Warning Notice we previously served in relation to regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been complied with and whether the provider had fulfilled their action plan to achieve compliance with legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led.
The ratings from the previous comprehensive inspection for those key questions not looked at this visit were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same as the last inspection, requires improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link Eastfield Residential Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to record keeping, consent to care, the management of risks, staffing, safeguarding, person-centred care and monitoring of improvements.
We have written to the provider and they have submitted an improvement plan. We will work closely with the provider to monitor their improvements.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Special measures
The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.