Eastbourne Grange

Safe recruitment had not been maintained. Documentation was not in place to ensure the provider could be sure staff were safe to work in the home. There were not enough trained staff to administer medicines in accordance with people's prescriptions. Only one senior carer and the registered manager were currently able to give people medicines when needed. There were no medicine audits or checks being completed. This meant issues related to safe medicine storage had not been promptly identified.

Accidents and incidents were not being robustly monitored. Actions had not been implemented following a suspected head injury and it had not been identified when an accident had not been reported externally to the local authority

Infection prevention control measures were not being followed in line with current government guidance. Staff were not wearing masks and no rationale or risk assessment had been recorded in relation to this decision.

The provider had not ensured there was adequate oversight of the service or support in place for the registered manager in light of a number of staff vacancies. New staff were not experienced and lacked the skills to provide care without being supported by other staff. This meant the registered manager was having to cover care tasks and administer medicines. This had impacted on the registered manager completing checks and audits to ensure the safety and management of the service had been maintained.

There was not an effective system in place to manage the environment and to review overall maintenance and safety in the home. A number of checks had not been completed in line with required timescales, this included water safety checks and fire safety. Window restrictors had not been checked and serviced. Fire safety systems needed to be improved to ensure people were safe. and staff were appropriately trained to respond to an emergency and evacuate people in the event of a fire.

The provider had failed to ensure there was adequate governance at the home. Auditing was not robust or consistently completed. Required checks had not all been completed. Care documentation needed to be

improved to ensure care plans and risk assessments provided the most up to date information. When decisions had been made, for example, regarding medicine administration or in relation to PPE, no risk assessment or rationale had been recorded.

Improvements were being implemented in relation to people's consent and best interest meetings being recorded when needed. 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. The registered manger had been working with the local authority to ensure best interest meetings and capacity assessments where in place to support decisions made.

Relatives spoke positively about the service and the care their loved one received. People told us they liked staff but would like more consistency as they felt they responded better to staff they knew and trusted.