Archived: Eachstep Blackley

Updated 9 July 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by an inspector, an assistant inspector and an Expert by Experience on the first day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The inspector returned for the second day of the inspection.

Service and service type

Eachstep Blackley is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with eight people who used the service and nine relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, deputy service manager, clinical lead, nurses, senior care workers and care workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included nine people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality assurance were reviewed.

Updated 9 July 2019

About the service

Eachstep Blackley is a nursing and residential care home providing personal and nursing care to 55 people aged 65 and over at the time of the inspection. The service can support up to 60 people.

The home has two nursing households and three residential households for people living with dementia across three florrs. Each household is able to accommodate up to 12 people. Each household has a kitchen, dining and lounge area. All bedrooms have an en-suite shower, with adapted bathing facilities available on each floor.

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

People across the service had person-centred care plans and risk assessments in place. These identified people’s support needs and gave guidance for care staff in how to meet these needs.

Since our last inspection, the quality assurance system had been improved and was more robust. A planned series of audits were undertaken and management reports monitored a range of topics, including people’s weights and pressure area care.

People received their medicines as prescribed. Staff liked the electronic medicines administration record system as they thought it reduced the risk of medicines errors being made.

People and relatives thought they were safe living at Eachstep Blackley. All accidents and incidents were recorded and reviewed to identify any actions to reduce the risk of a re-occurrence.

Equipment was checked, maintained and serviced in line with regulations and guidelines.

Staff were safely recruited. There were sufficient staff to meet people’s needs, but staff were busy at key times which meant there were no staff in the communal areas of the households for up to 20 minutes at a time. This could be a risk if people became anxious. Domestic staff completed all care courses and were visible on the households during the morning busy period.

Staff received the training and support to carry out their roles. Staff were positive about the support they had from the nurses, senior carers and managers.

The home was visibly clean throughout. People and relatives told us it was always clean.

People were supported to maintain their health. Referrals were made to medical professionals appropriately. Medical professionals were positive about the home, saying staff were always available to support the person during their visit and knew the people they were coming to see.

People were supported to maintain their food and fluid intake. Meals were bought prepared and so had the correct nutritional values and consistency. People’s weights were monitored and fortified foods offered to those at risk of losing weight.

People and relatives said that staff treated them with dignity and respect. Staff clearly explained how they maintained people’s privacy and independence when providing support.

People’s cultural needs were recorded and were being met. A range of culturally appropriate meals were available. People’s communication needs were recorded, and staff knew how they communicated and made decisions.

People and their relatives were involved in agreeing the care plans. Meetings were held for residents and relatives to gain their feedback. An annual survey was also conducted.

A planned activity was arranged each day, mainly in the afternoons. We did not observe staff having the time to engage people in activities on the households as they were busy supporting people.

Eachstep had a range of links with the local community, including local schools and students volunteering at the service as part of their health and social care college course. The building was used as a community hub, with a café and space for community groups to meet, for example a dementia support group for people living in the local area.

Many people’s end of life wishes were not recorded. The registered manager said a lot of people did not want to discuss this. A new model to support people at the end of their lives called Palliative Care for Older People (PACE) was being introduced. However, the recording of end of life wishes had not progressed since our last inspection when a model of care called the Six Steps was to be used to encourage people to discuss their end of life wishes.

A relative told us the end of life support for their relative was very good. Staff knew the support they required to be comfortable.

Complaints were responded to appropriately.

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 26 June 2018) and there were three breaches of regulations. The provider completed an action plan after the last inspection 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.

Follow up

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