About the service Eastwood House is a residential care home providing personal care to 16 people aged 65 and over at the time of the inspection. The service can support up to 19 people.
People’s experience of using this service and what we found
There were widespread and significant shortfalls in the way the service was led. There were three breaches of the Health and Social Care Act 2008 (Regulations) 2014.
People's care records did not always reflect their current care needs and increased the risk to people’s health and safety. People were at risk from infections because the infection prevention and control processes were not always effective. The environment in which people lived and staff worked was not appropriately maintained in places. The provider had not acted to address this. People were not always supported by sufficient numbers of suitable and experienced staff because there were not enough permanent workers employed by the home.
Governance and management systems were not always reliable and effective. The home lacked the drive for improvement to address many of the significant concerns we raised during our last and this inspection. Support for staff from management was inconsistent. The provider did not have up to date policies and procedures in place for staff to follow.
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.
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 29 October 2019) and there was one breach of regulation. The provider was asked to complete an action plan after the last inspection to show what they would do and by when to improve. The provider had failed to complete an action plan.
At this inspection not enough improvement had been made and the provider was still in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 16 and 17 September 2019. A breach of legal requirements was found. The provider had not completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to inadequate. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eastwood House on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to assessing and managing risks to people, infection prevention and control processes and the management and governance of the home at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore 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 6 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 rating, 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.