Eckling Grange

People who used the service were supported by enough staff who had the skills and training to support them safely. Staffing was slightly reduced at weekends but was still in excess of the service’s own safe staffing levels. Staffing for people in the onsite bungalows was carefully monitored and had no impact on the staffing of the main service. Staff were safely recruited and underwent an induction process. Many staff had been in post a number of years or had returned back to the service after a period away creating a very stable staff team. Staff were well supported by the management team. Some staff received additional training to enable them to administer medicines and had their competency to do this checked. Medicines were safely managed and people received their medicines, including those for pain, as prescribed.

Staff understood their responsibility to report and act on safeguarding concerns, should they suspect a person was at risk of abuse or experiencing abuse. The registered manager reported safeguarding concerns to the local authority safeguarding team and to CQC and managed any incidents well. One issue, which had the potential to pose a safeguarding risk, had not been sufficiently risk assessed. We brought this to the provider’s attention, and they took immediate action to address this.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives.

Risks were identified, mitigated and well monitored to ensure changes to risk assessments were not required. The provider gave us assurances relating to people living with dementia potentially accessing unsafe items to try to eat. This is not a current concern, but they have committed to review the environment in the light of this potential future risk.

The service was clean and odour free and we had no concerns relating to infection prevention and control. The environment was safe and people were able to access areas of the service independently including the extensive grounds. There was a secure area of the grounds enabling people living with dementia to enjoy outside space independently and safely. Equipment, such as hoists and stand-aids, was well maintained. Maintenance staff carried out regular safety checks to ensure systems, such as the fire system, were working correctly and the building remained in a good state of repair.

People’s needs were assessed prior to coming to live at Eckling Grange and regularly reviewed. People’s needs relating to their eating and drinking were well documented in care plans although we identified one person could benefit from increased oversight relating to fluids. The provider acknowledged this and gave us assurances fluid recording and oversight would be discussed at the next staff meeting. People were provided with a nutritional diet with plenty of choice. Health needs were well monitored and appropriate referrals made when needed, to the falls team or speech and language therapists for example. There was good partnership working with local health professionals to maintain and support people’s health. People consented to their care and staff demonstrated a good understanding of people’s right to make their own decisions, even when these were sometimes considered unwise. People who lacked capacity to make their own decisions were enabled to make them through a structured MCA process. This involved legally recognised representatives helping to make decisions in the person’s own best interest. People were given opportunities to feedback on all aspects of the service in surveys, meetings and the electronic visitor book. The provider took note of people’s feedback, and we saw evidence of the registered manager following up issues diligently, however minor.

Care was person centred and staff were kind and demonstrated supportive and enabling relationships with the people they were supporting and caring for. Although the service had a busy and bustling atmosphere, care was unhurried and people were supported with kindness and dignity. Staff provided individualised care and knew people very well.

There was good oversight by the registered manager and general manager, supported by a deputy and heads of care. Between them they monitored all systems and processes well. Staff were well supported with supervision sessions and staff meetings and communication was good. There was a commitment to growing and innovating and a plan of improvements in place including the Journey of Memories Garden which was already underway. There was a shared direction and culture based on Christian faith but not excluding those of other or no faith. Commitment to Christian faith and values was woven throughout the service and created a cohesive community.