Our inspection on 22 July 2014 and the evening and following morning of 29/30 July 2014 was carried out by two Adult Social Care Inspectors. We gathered evidence to help us answer our five questions; is the service safe, effective, caring, responsive and well-led?Below is a summary of what we found. The summary describes the number of different methods we used to help us understand the experiences of people who used the service. During our time at Eagle Wood Neurological Care Centre we looked at records, policies and procedures; we undertook observations, we spoke with four people who used the service, four relatives of people who used the service and six staff members. We also spoke with the registered manager and representatives of the provider.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
The Care Quality Commission (CQC) had received some information of concern following the previous inspection carried out on 25 April 2014. As such, during this inspection of 22, 29 and 30 July 2014, we looked at eight out of 75 people's care records. We saw that health care plans and risk assessments regarding people's individual support, care and health needs were carried out. We saw that measures were in place to minimise those risks. During our inspection we found no evidence to support the concerns raised.
The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLs), which applies to care homes. The provider advised us that, at the time of our inspection, Deprivation of Liberty Safeguard (DoLS) applications had been made for some people who used the service. The provider demonstrated to us their knowledge and we saw that they had DoLs and Mental Capacity Act 2005 (MCA) policies and procedures in place.
Staff we spoke with told us that they understood their role in safeguarding the people they supported. They demonstrated to us their understanding of safeguarding and what they were to do and who they would contact if they had a concern.
We found that not all of the improvements needed had been made since our previous inspection which we carried out on 25 April 2014. We found that records made when medicines were given to people were up to date. However, we found some discrepancies between the quantity of medication held in stock and what should have been if these records were accurate. We could not be assured that people were given their medication as prescribed.
The staff rota we looked at for the evening and night time part of our inspection demonstrated to us that the provider took into account people's complex care and health needs when making decisions about the staff skill mix and staff numbers. The CQC has had concerns raised with them about the number of agency staff the provider use. We spoke with the provider about this concern during our inspection and the provider told us about their on-going recruitment of permanent staff.
Is the service effective?
Improvements had been made by the provider from the inspection carried out on 25 April 2014. During this inspection of 22, 29 and 30 July 2014 we found written evidence that people had consented to their care, support and treatment. Where people who used the service were unable to consent we saw evidence of legally appointed support in place, as well as appropriate family involvement.
People's care, support and treatment needs had been assessed and health care plans were in place within the care records we looked at. We also found that where appropriate, people's wishes for their end stage of their life, care and support was discussed with them or appropriate next of kin and their wishes were recorded within their care records.
We found that improvements had been made since our previous inspection on 25 April 2014. Our inspection of 22, 29 and 30 July 2014 found that staff who had been working at Eagle Wood Neurological Care Centre for over one year had regular supervisions and an appraisal.
Is the service caring?
Relatives we spoke with had positive comments about the care, support and treatment received. One relative told us that the service was, 'First class, (they) provide good care and (my relative) is looked after'. Whilst two other relatives told us that they were happy with the general care, but felt that there were still some improvements to be made by the provider. In addition, one out of the four relatives we spoke with told us that the care and support had not met their expectations.
Care records we looked at demonstrated to us that people were supported to live as independent life as possible with assistance from staff. We found that people's equality and diversity, interests and likes and dislikes were recorded.
Is the service responsive?
Three out of four relatives we spoke with told us that the support and care met their relative's needs.
In the care records we looked at we saw that healthcare professionals were involved in people's care, support and treatment. We noted documented evidence that people were supported to attend external healthcare appointments.
Is the service well-led?
The majority of people who used the service and their relatives we spoke with told us told us that they could discuss any concerns they might have with the provider and that their visits to Eagle Wood Neurological Care Centre were encouraged by staff.