Background to this inspection
Updated
20 February 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team consisted of two inspectors who visited the service on one day and a member of the medicines team who reviewed records remotely following the inspection visit. An Expert by Experience also assisted with video calls to people who live at the service and phone calls to some relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Eastleigh Raleigh Mead is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 nine staff including the manager, NI (The nominated individual is responsible for supervising the management of the service on behalf of the provider.), lead nurse, care staff and housekeeping staff. We reviewed some electronic information including care files, two recruitment files and 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.
After the inspection –
We asked for some policies and records to be sent to us following the inspection. This included audits on falls, medicines, staff training, infection control policies and policies relating to Covid and outbreaks. The Expert by Experience spoke with five people who lived at the service via video link and five relatives via phone calls. We also had feedback from two healthcare professionals.
The medicines part of this inspection was conducted remotely and via telephone discussion with management. We checked eight people’s medicines records, and reviewed systems for incident reporting, auditing, staff competencies and training. Medicines storage and expiry dates were checked on-site.
Updated
20 February 2021
About the service
Eastleigh Raleigh Mead is a residential care home providing personal and nursing care to 61 people aged 65 and over at the time of the inspection. The service can support up to 61 people. Most people living at the service are living with dementia and have nursing needs.
The service is purpose built with communal areas and bedrooms on three floors, all accessed by a lift and stairs.
People’s experience of using this service and what we found
Most people were unable to give an informed view about their experiences of living at Eastleigh Raleigh Mead. Those who could were positive about their experiences in the main. Comments included “I’ve never been so well looked after, I want for nothing”. Also, “Safer than I would be at home, I call it the ‘little fortress” One relative commented “I’ve no complaints at all. I’m extremely happy with the way they treat me and my family.”
Our observations showed us people were being treated with kindness, respect and dignity. Staff were attentive and understood people’s individual needs.
At the last inspection we found medicines were not always managed safely. We issued a requirement in relation to this as people were at risk. We asked for and received an action plan which showed what the provider was doing and implemented to ensure this requirement was met. At this inspection we found medicines management had improved since our previous inspection. People received their medicines safely and in the way prescribed for them.
At the last inspection we found specialist mattresses were not always at the correct setting for the person using this equipment. Following feedback the provider implemented daily checks of the mattresses. During this inspection we found this was working well and mattresses were being checked daily.
At the last inspection we found quality audits had not identified issues of concern and in particular those relating to medicines. We issued a requirement in relation to this as people were at risk. We asked for and received an action plan. This showed what the provider was doing and had implemented to ensure this requirement was met. At this inspection we found audits had been updated and there was clearer overall oversight of the service.
At the last inspection we found staff morale was low and there were mixed reviews about the management approach within the home. Since this inspection a new manager had been appointed. They were not yet registered with CQC. Staff were positive about the new manager and described the staff morale as being good, and the new manager being inclusive. Despite the pandemic and staff having to work in exceptional circumstances most described the working environment as supportive and having a good team spirit. One staff member said “We are very well supported here. They take the time to listen. I had a really bad year and the management team were invaluable in supporting me.”
There were sufficient staff with the right skills and support to provide safe and effective care to people. Staff recruitment was robust and ensured only staff who were suitable to work with people who may be vulnerable were employed.
Quality audits, systems and record keeping were being reviewed and updated to ensure a consistent approach, which could be easily monitored, was being implemented. This included the introduction of a new electronic system which would allow for remote auditing of key areas such as people’s nutrition and hydration.
We were assured that the infection control measures, PPE and guidance on working in a pandemic were being followed to keep people safe. The provider had invested in some key improvements which included a temperature sensor at the main entrance to check all visitors temperatures. There was also a self contained visiting hub near the main entrance. This allowed visitors to meet with their families in a secure and risk reduced setting. There was a floor to ceiling screen and a sound system to allow for better communication through the screen. There is a staff member designated for these visits. They take responsibility for getting people ready for the visits, supporting them if needed during the visit and the cleaning in between visits.
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 February 2020)
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 focussed inspection based on the previous rating.
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 coronavirus and other infection outbreaks effectively.
This inspection looked at the key areas of safe and well led as this is where previous breaches had been identified.
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.
The overall rating for the service has changed from requires improvement to good. 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 Raleigh Mead on our website at www.cqc.org.uk.