Eastleigh Care Homes - Minehead Limited

Eastleigh Care Homes – Minehead Limited is a care home providing accommodation and personal and nursing care. It is registered to provide care to up to 69 people. Accommodation is provided in two buildings divided into different units. One unit provides nursing care to people living with dementia. One small unit cares for people with complex mental health needs and other areas of the home support people with general nursing and personal care needs.

At the time of our inspection there were 64 people using the service.

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

People felt safe at the home and with the staff who supported them. Throughout the inspection we saw pleasant and kind interactions between people and staff.

People’s medicines were generally managed safely, and they received them in the way prescribed for them. However, there were some medicines supply problems, which the managers were working with the supplying pharmacy and the GP surgery to improve.

People had their needs assessed before they moved to the home. We found that these assessments needed to be more comprehensive and have recommended that the provider reviews their preadmission process.

The dining experience and environment for people living with dementia would benefit from improvement to promote dignity and independence. The provider had already identified some of these issues and was taking action to address them.

People did not always have their specialist needs met because professionals and the staff at the home had not worked in partnership to support people.

Due to the large variety of needs and ages of people at the home some people felt their social needs were not always met. The provider told us they had employed an additional worker to help support people with meaningful occupation.

People were supported by adequate numbers of staff who had been safely recruited.

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.

Staff understood the principles of the mental capacity act and made decisions in people’s best interests where needed.

The provider had effective systems in place to identify shortfalls in the service and plan improvements. The providers own monitoring had highlighted areas for improvement, and they were working towards making changes to improve care provided to people.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. At the time of the inspection the home was providing care to a small number of people with a learning disability.

Right support

People lived in a large nursing home which did not specialise in the care of people with a learning disability. One person had one to one staffing at times to support them to pursue their interests and hobbies.

However, another person who was staying for a respite period had a lack of support to take part in activities which were appropriate to their needs.

There were limited opportunities for people to access their local community for leisure or education.

People’s physical healthcare needs were monitored by trained nurses and senior staff.

Right Care

People received kind and compassionate care from a friendly staff team.

People had not all had opportunities to discuss their aspirations and set goals.

Right Culture

People were supported by a manager and provider who worked hard to promote a culture where people were valued and respected as individuals.

The manager and provider were open and transparent and took action to make sure people were protected from avoidable harm.

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 Good (published 14 May 2021.)

Why we inspected

We received concerns in relation to the management of medicines and staff skills to provide good quality care to people with complex needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We found evidence that the provider had already identified these issues through their quality monitoring systems and was taking action to make improvements.

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 effective and well led section of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eastleigh Care Homes – Minehead Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Eastleigh Care Home – Minehead Limited is a care home for up to 69 people. The home provides nursing and personal care. It specialises in the care of older people, including people living with dementia. At the time of the inspection there were 58 people living at the home.

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

Overall, medicines were being managed safely. However, we have made a recommendation about medicines management, specifically around information relating to time critical medicines to ensure they are administered as prescribed.

People were comfortable and relaxed at the home. Risks of abuse to people were minimised because staff knew how to recognise and report signs of abuse. Staff told us they would be confident to report their concerns to the provider.

People were able to receive care and take part in their chosen activities safely. This was because risk assessments were carried out, and control measures identified, to minimise risks.

There were sufficient staff to keep people safe and to meet their needs. Staff responded promptly to people to make sure they did not wait an unreasonable amount of time when they required assistance.

People lived in a home which was well maintained and safe. Staff followed up to date guidance on infection prevention and control to minimise risks to people.

People could be confident that the home was well managed by the provider. There were systems to monitor standards of care and plan ongoing improvements.

People and their representatives were kept up to date with any changes at the home. Staff supported people to keep in touch with friends and relatives in accordance with up to date government guidance.

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

Rating at last inspection

The last rating for this service was Good (report published 29 November 2017.)

Why we inspected

We received concerns in relation to people not having their safety needs met. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We found no evidence during this inspection that people were at risk of harm from these concerns.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating 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.

The overall rating for the service has not changed. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eastleigh Care Home – Minehead Limited 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 re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection in September 2015, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good;

People felt safe at the home and with the staff who supported them. One person told us, “Although I can’t do much for myself, they are always kind to me which makes me feel very safe indeed.”

There were systems and processes in place to minimise risks to people. These included a robust recruitment process and making sure staff knew how to recognise and report abuse. There were adequate numbers of staff available to meet people’s needs in a timely manner.

People received effective care from staff who had the skills and knowledge to meet their needs. One person said, “The care here is good. Actually it’s a very high standard.” Staff monitored people’s health and well-being and made sure they had access to other healthcare professionals according to their individual needs.

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

People were supported by staff who were kind and caring. Where people found it difficult to express themselves, staff showed patience and understanding. One person told us, “Staff are nice. They are gentle and kind.”

The service was responsive to people’s needs and they were able to make choices about their day to day routines. People had access to a range of organised and informal activities which provided them with mental and social stimulation.

People could be confident that at the end of their lives they would be cared for with kindness and compassion and their comfort would be maintained. The staff worked with other organisations to make sure high standards of care were provided and people received the support and treatment they wished for at the end of their lives.

People said they would be comfortable to make a complaint and were confident action would be taken to address their concerns. The registered manager and provider treated complaints as an opportunity to learn and improve.

The home was well led by an experienced registered manager and management team. The provider had systems in place to monitor the quality of the service, seek people’s views and make on-going improvements.

Further information is in the detailed findings below.

We heard the unification of the two services had enabled people to access a range of care as their needs changed. Staff were also able to access an increased range of training and experience.

The service was managed overall by the registered manager. The deputy manager took particular responsibility for the care of people and staff in the residential building. During the inspection we met with the clinical lead for the provider and were told about their role in ensuring the standards of nursing and care throughout the home.

Our inspection set out to answer five questions:

Is the service safe?

Is the service caring?

Is the service responsive?

Is the service effective?

Is the service well-led?

Below is a summary of what we found. It is based on our observations during the inspection, discussions with people living at the home, and with the staff supporting them, and on looking at records.

Is the service safe?

People told us they felt safe. Staff treated people with kindness and respect. Safeguarding procedures were in place and action was taken to keep people safe. Arrangements were in place to make sure that the registered manager and staff learnt from incidents and investigations.

Staff we spoke with were aware of the Mental Capacity Act 2005 and how to support people who were unable to make decisions for themselves. Staff were able to tell us about how they had involved other people in making decisions when someone lacked the capacity to make a decision for themselves.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. Relevant staff have been trained to understand when an application should be made, and how to submit one. People's rights were therefore properly recognised, respected and promoted. People who needed extra support to make decisions were able to use an independent advocate.

There were systems in place to ensure that medicines were safely stored, administered and disposed of. We heard medicines were only administered by registered nurses or senior staff who had completed appropriate training and been assessed as being competent to carry out the task.

Is the service caring?

People were supported by kind and caring staff. All of the people we spoke with told us that they were happy at the home. One person told us 'I couldn't have come to a better place. The carers care, the management is good and the food is excellent.' Another person said 'We are really looked after here. Staff are great. We do more or less whatever we like.' A relative talked to us at length about the care their family member received. They said 'They know my Mum here. I thought this would be the right place for her and I was right.'

The provider conducted annual satisfaction surveys. The most recent survey showed high levels of satisfaction with the quality of care.

Is the service effective?

The service provided care in line with people's wishes and individual needs. This was recorded in care plans. People's health and care needs were assessed with them, and where possible they signed to show that they were involved in deciding the best care to meet their needs. Staff were trained in appropriate areas of care.

Is the service responsive?

The service responded to people's changing needs. When people were unwell or they needed specialist assessment, the provider sought advice from community health and social care professionals.

There were residents' meetings where people could suggest changes to the manager. We saw notes of these meetings that showed that the manager listened and made changes where they could.

People told us they felt able to make a complaint if they needed to. We saw when a complaint was made it was addressed and taken seriously.

Is the service well-led?

The service was led by registered manager who was supported by a deputy manager. Both managers knew the people living in the home very well and were actively involved in ensuring they received safe and effective care.

The service had a system of regular quality assurance that monitored care and showed where it could be improved.

Staff understood their responsibilities. They felt well supported by the provider and the registered manager. We heard from people who lived in the home and staff that the manager was accessible and 'always listened.'