Archived: Eastwood Promoting Independence Centre

We found the following examples of good practice.

The registered manager had identified, assessed and mitigated all COVID-19 related risks to people, staff and visitors.

The registered manager had an effective monitoring system in place to check that the service was following government guidance and the provider's own policies.

Staff were confident and knowledgeable about government guidance and what visitors were required to do prior to entering the service. Professional visitors provided a negative lateral flow test which was no more than 72 hours old prior to entering the service.

People were encouraged and supported to leave the service to visit relatives or access the local community. Relatives were able to visit their family members in communal areas and their bedrooms.

Staff and people received regular testing for COVID-19. Staff wore appropriate PPE and had access to this throughout the home. Staff had received additional training during the pandemic about correct PPE usage and infection prevention and control from the provider.

Eastwood Promoting Independence Centre is a care home providing personal and nursing care for up to 26 people. The service provides short-term care to support people to be independent and be able to return to their home. 20 people were using the service at the time of our inspection.

People’s experience of using this service and what we found

Due to the circumstances surrounding Covid-19 at the time of inspection we were unable to speak with people using the service directly. Relatives we spoke with after the inspection said they felt their family member received care that met their individual needs. One relative said “My experience has been excellent, and all the staff have been professional and empathetic in their approach. [Family member] has said how lovely all the staff have been, and they felt very well looked after and heard.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. One staff member said, “We as staff will always strive to act in the best interest to represent a service user who lacks capacity, in line with mental capacity assessments service user’s will be supported to make their own choices.”

People were supported to have enough to eat and drink. Staff were aware of people’s dietary needs and preferences and the actions to take should they be concerned about people’s nutritional intake. People had access to healthcare professionals to ensure their emotional and physical well-being needs were met.

During the last inspection we found some staff were not up-to-date with essential mandatory training. Gaps were also identified in staff supervision records. Improvements to the provision of training and supervision had been implemented since the last inspection. People were supported by staff who had access to a range of training to develop the skills and knowledge they needed to meet people’s needs. Sufficient improvement had been made at this inspection and the provider was no longer in breach of regulation 18.

At the last inspection of the service the provider had failed to ensure governance systems were

sufficiently effective to monitor and improve the quality and safety of the service. Since the last inspection quality assurance systems had been put in place to monitor the quality of service being delivered. The registered manager had a home improvement plan in place which identified areas for development.

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 service was rated requires improvement at the last inspection (published 16 May 2019). Following the inspection, the provider submitted an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. We completed this focused inspection to make sure they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to two key questions, Effective and Well-led.

The ratings from the previous comprehensive inspection for those key domains not looked at during this inspection were used in calculating the overall rating for this inspection. The overall rating for the service therefore has improved to Good, based on the findings at this inspection.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Eastwood Promoting Independence Centre on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: During our inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to staffing.

A review of the provider’s training matrix identified some staff were not up-to-date with essential mandatory training. Gaps were also identified in staff supervision records.

People and their relatives told us the care they received from staff was good. They told us staff knew and fully understood their needs. People living at the service were usually only there for a period of six weeks. During this time, people’s needs were either assessed to allow them to undergo rehabilitation with the aim of returning to their own home, or people were assessed to determine what would best meet their longer-term needs.

People told us they felt safe. The provider had safeguarding policies in place and records confirmed this process was followed. People told us there were enough staff to look after them. Recruitment of staff remained good. Care plans included individual risk assessments, which were regularly reviewed to keep people safe. Medicines continue to be managed safely. Regular premises safety checks were carried out.

The provider worked closely with various healthcare professionals, some of whom were based on site. People also had access to healthcare services such as GPs, dieticians and dentists.

People were supported to maintain a healthy diet and people told us they enjoyed their meals. The environment had been designed to support and encourage people to achieve a greater level of independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, policies and systems in the service supported this practice.

People and their relatives were involved in the creation of care plans. Care plans were reviewed on a weekly basis and where necessary changes were made.

People were encouraged to provide feedback of their experience of the service. Regular meetings were held with people who used the service to discuss ideas for improving the home. People were encouraged to participate in a range of activities.

People, staff, relatives and healthcare professionals spoke in positive terms about the registered manager. Staff told us that the registered manager was both supportive and approachable.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (report published September 2016)

Why we inspected: This was a planned inspection based on the rating at the previous inspection .

Follow up. We have asked the provider to send us an action plan telling us what steps they will take to make the improvements needed. We will return to re-inspect this service within the published timeframe for services rated requires improvement.

We last inspected Eastwood Promoting Independence Centre in March 2014. At that inspection we found the service was meeting the legal requirements in force at the time.

Eastwood Promoting Independence Centre is a service that provides nursing and personal care for up to 26 older people, some whom may live with dementia. The service provides short stay, assessment, intermediate care and rehabilitation to help promote people’s independence to help them return to their own home. Nursing care is now provided at the service as a multi-disciplinary team of health and social care professionals provide care and treatment to people.

A registered manager was in place. 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.

People said they felt safe. Staffing levels were working and were appropriate for the service as it was currently operating. However, we considered that this would need to be kept under review as occupancy levels increased in order to ensure the ethos of the service was supported and all people received timely and individual care. Care was provided with kindness and people's privacy and dignity were respected.

All people spoke positively of the service they received. They told us staff were kind and caring. People welcomed the opportunity to stay at the service and receive some rehabilitation in order for them to regain their independence and in most cases return home.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. Staff were aware of the whistle blowing procedure which was in place to report concerns and poor practice. There were processes in place to ensure that any issues or concerns were responded to appropriately.

Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, where decisions were made on behalf of people who were unable to make decisions themselves. Other training was provided to help ensure people's needs were met although not all training for safe working practices was up to date. Staff were supervised and supported.

The environment was mostly well-maintained. We considered improvements were required to communication to ensure staff were kept up to date about people’s well-being.

People received their medicines in a safe and timely way. People were supported by health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care and support they needed.

Menus were varied and a choice was offered at each mealtime. Staff supported people who required help to eat and drink and special diets were catered for. There were activities and entertainment available for people.

A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to. People had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service. The provider undertook a range of audits to check on the quality of care provided.

Staff and people who used the service said the registered manager was supportive and approachable. Tere were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care.

We saw that records were up to date and fit for purpose. Records were accurate and stored securely.

We saw people were cared for effectively and care was planned in a way that ensured the safety of people.

There was sufficient suitably qualified and experienced staff on duty to ensure the safety and welfare of people who used the service. We saw the premises were safe and suitable.

The provider had an effective system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.

We saw records were not always accurate and appropriately maintained.

People who used the service were positive about the care and support provided. Comments included 'I'm very pleased with the care I receive. I don't have to ask for anything they just do it' and 'I have no problem with the carers. I trust them