Eaton Court

Updated 28 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 16 and 19 February 2018. On the first day the inspection was unannounced and was undertaken by one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert had experience of older people and dementia care. We told the registered manager at the end of the first day of the inspection we would return to the service on 19 February 2018 to finish the inspection.

Before the inspection, the provider was asked to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We considered this information during our inspection. We also looked at the notifications received and reviewed all the intelligence the Care Quality Commission held to help inform us about the level of risk for this service. We asked the local authority for their views about the service prior to our visit. We reviewed all of this information to help us to make a judgement about the service.

We looked at how the service used the Mental Capacity Act 2005 to ensure that when people were assessed as lacking capacity to make their own decisions, best interest meetings were held in order to make important decisions on their behalf.

During the inspection we spoke with six people who used the service, two relatives, two visitors and 12 staff, which included the activities co-ordinator and cook. We also spent time observing the interactions between people, relatives and staff whilst in the communal areas of the service.

We looked at a selection of documentation relating to the management and running of the service. This included three staff recruitment files, three staff supervision records, staff training records and rotas. It also included four people's care records and four medicine administration charts, minutes of meetings held with people who lived at the service and relatives, quality assurance checks and audits, policies and procedures, maintenance records and complaints and compliments. We undertook a tour of the building. We also asked the local authority for their views about this service.

During the inspection we observed how staff interacted with people who used the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people using the service.

Updated 28 March 2018

The inspection took place on 16 and 19 of February 2018.

At the last inspection of this service in January 2017 we rated this service as requires improvement in safe and well-led, which meant the quality rating of the service was requires improvement overall. We found two breaches of legal requirements because staff were not completing monitoring charts which showed the amount of fluids and support people were receiving and there was a failure to ensure documents were up to date and showed a full and contemporaneous account of people's needs and how their welfare was being monitored. There was a lack of an effective auditing system to ensure people's need were met. These issues were breaches of Regulation 9, Person-Centred Care and Regulation 17, Good Governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. During this inspection we found improvements had been made to meet the relevant requirements.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe and well-led to at least good. We found at this inspection people were receiving appropriate care and support and this was documented. We found the service was monitored appropriately and effective auditing and monitoring was in place to help staff assess if people’s need were met.

Eaton Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

Accommodation was provided for up to 45 people over two floors. Eaton Court is close to a bus route, and local facilities are within walking distance. During our inspection there were 35 people using the service.

The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff protected people from harm and abuse and understood how to report concerns to the management team, local authority and to the Care Quality Commission. This helped to protect people.

Staffing levels were monitored daily to make sure there was enough skilled and experienced staff to meet people’s needs. Staff undertook training in a variety of subjects to maintain and develop their skills. Supervisions and appraisals were provided to support staff and to identify any further training needs. Staff recruitment procedures were robust.

There were adequate infection prevention and control measures in place at the service. General maintenance was undertaken. Accidents and incidents were monitored and emergency plans were in place to help to protect people’s health and safety.

Medicines were effectively managed. People received their prescribed medicine in a timely way from staff who undertook this safely.

People’s preferences for their care and support were recorded. People were treated with dignity and respect. Care records were personalised and people’s communication needs were known by staff. Risks to people’s wellbeing were monitored and staff encouraged people to maintain their independence, where possible. Staff contacted health care professionals for help and advice to maintain people’s wellbeing.

People’s mental capacity was assessed. We found care and support was provided in line with the Mental Capacity Act 2005. Staff encouraged people to make choices about how they wished to live their life, where possible.

People were treated with kindness and their diversity was respected. There was a confidentiality policy in place for staff to follow. Care records were stored securely in line with current data protection legislation.

A complaints policy was provided to people and issues raised were dealt with. Information was provided about advocacy services so people could gain help to raise their views, if they wished.

Visiting was permitted at the service. People were encouraged to maintain contact with family and with friends. There was a programme of activities provided for people, which now occurred at the weekend.

The registered manager was open and transparent. Quality assurance checks and audits were taking place to maintain or improve the service. A new electronic care record system was being introduced to free up staff and to ensure care records were always kept up to date. The environment was being further enhanced for people living with dementia. Work was being undertaken to ensure people who preferred to spend their time in their bedroom from becoming socially isolated. The registered manager was looking at how the location of staff at the service could be indicated to people living there and to visitors.