Eastfield

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People’s needs were not always robustly assessed to ensure their needs were met. Although staff used recognised tools to assess people’s needs, they did not always act on the information from the tool, for example to refer to a dietician. Tools were not re completed when people’s needs changed, for example when people lost significant weight. People’s capacity to make decisions was not always robustly assessed and processes followed in line with legislation. The registered manager did not ensure that decision making was documented and that restrictions placed on people were regularly reviewed. We found 2 breaches of the legal regulations in relation to safe care and treatment, and the need for consent.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not always receive safe care and treatment. Another person lost 6kg in weight over 2 months following a hospital admission. Their care plan was not reviewed or updated following the hospital admission. Although staff used a MUST tool, this had not been reviewed or updated following the hospital admission. The registered manager had not assessed the need to increase the person’s calorie intake, for example by adding cream to food or encouraging more snacks.

People’s needs were not always assessed and updated. Care plans were not always reflective of people’s needs. For example, one person’s care plan stated they needed to be seen by the chiropodist every 6-8 weeks. The registered manager told us this information was incorrect, however following the assessment they sent us records to show that the person had been seen regularly since May 2024 by the chiropodist. Another person living with diabetes did not have a care plan to inform staff how to support them with their footcare. We asked the registered manager if they had been seen by the chiropodist and they confirmed they had, but they were only able to demonstrate they had been seen once in 2024. Following the assessment the provider sent us confirmation that the person had been seen regularly by a chiropodist.

Processes to ensure people’s needs were assessed and met were not effective. We identified that 5 people did not have a toothbrush in their room. One person’s toothbrush was visibly dirty, and this had not been identified by staff. We reviewed daily notes for people and found that they had not been supported to clean their teeth for long periods of time. For example, one person had been supported to clean their teeth once in a week. Another person’s records showed they had been supported to clean their teeth twice in one week. Although staff were using recognised tools to assess people’s needs, they were not always using them effectively. For example, one person’s Waterlow assessment stated they were at ‘very high risk’ however there was no information on what actions to take to reduce the risk to the person. The Waterlow Score calculates the risk of pressure ulcers developing. The registered manager had failed to identify when people were not having their medicines, due to them being asleep. They had not taken action to review the time the medicine was prescribed and administered. They had not approached the GP to discuss amending the time the medicine was prescribed to enable the person to receive the medicine.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People who had capacity, had restrictions placed on them; there was no evidence that these were discussed with people, and they agreed to the restrictions. For example, one person’s bedroom was accessed via a key pad, which they did not have access to. Staff told us when the person wanted a drink, or food they would bang on the door for staff attention. Staff told us they had capacity to agree to living with the restriction, however there was no evidence this had been discussed with the person.

Staff we spoke with lacked knowledge about the Mental Capacity Act 2005 (MCA). For example, one staff member told us, “Mental capacity all good, sometimes she will fall over.” Staff and the registered manager did not always ensure people’s capacity was assessed and documented and they were supported in line with the MCA.

Processes were not effective to ensure that people’s capacity was assessed, and that best interest meetings were held and documented when people lacked capacity. For example, one person had been prescribed medicine to reduce their distress. The registered manager had not assessed the person’s capacity to consent to the medicine, or conducted best interest meetings to assess if the person was deemed to lack capacity to make the decision. When people had restrictions placed on them, there was no review of these restrictions to ensure they remained the least restrictive option for people, or to review alternative options.