Eastbourne Care Home

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

Effective – this means we looked for evidence that people's care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection under the previous provider, we rated this key question good. Following this assessment, the rating for this key question has changed to requires improvement. This meant the effectiveness of people's care, treatment and support was inconsistent.

The provider was in breach of 2 legal regulations in relation to the safe care and treatment of people and good governance .

This service scored 42 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

An effective system was not fully in place to ensure people’s needs were assessed in line with their needs.

Whilst people raised no concerns regarding this area, we identified shortfalls regarding the assessment of people’s specific medical conditions, medicines management, managing distressed behaviours, meeting people’s social needs and their nutrition and hydration. These shortfalls posed a risk to people’s health and wellbeing.

An effective system was not in place to ensure care was delivered in line with standards, guidance and the law.

We received concerns from 3 people and several staff about people’s care and support at night which they said did not meet people’s needs or preferences.

Several people were prescribed thickener (to be added to drinks and used for swallowing difficulties). However, people were not safely supported because clear guidance was not always available, and records did not evidence that thickener was administered as prescribed. In addition, staff were administering thickener to one person which was not prescribed.

The recording and monitoring of fluids did not always keep people safe. Fluid balance records were not always accurately recorded, reviewed or actioned in a timely manner. These issues posed a risk to people’s health and safety.

We spent time with people over mealtimes. Staff supported people in a calm, unhurried manner. Staff offered people choices and second helpings and provided encouragement throughout the mealtime for those who were reluctant to eat.

Systems relating to how staff, teams and services worked together were being improved.

The staff handover process was not effective, resulting in information not being passed between shifts. A new handover system was implemented during our assessment to strengthen communication between staff.

There had been a delay in obtaining and sending blood and urine samples for analysis. Staff informed us that procedures had been improved to help reduce the risk of this happening again.

Visiting health care professionals told us staff contacted them if there were any concerns about people’s care.

An effective system was not fully in place to support people to live healthier lives.

Whilst people and relatives did not raise any concerns in relation to this area; we found there had been a delay in obtaining and sending urine and blood samples for

analysis. This meant 1 person had not received treatment for a urine infection promptly.

We identified shortfalls relating to the assessment, monitoring and delivery of care relating to people’s specific medical conditions. A person did not have a respiratory care plan in place, despite them having a chronic respiratory disorder. Guidance to support staff in relation to another person’s diabetes management was not detailed.

A person had not been referred to the dietitian in line with the provider’s nutrition policy for weight management advice.

An effective system was not fully in place to ensure people’s health, safety and wellbeing were monitored to ensure they achieved positive outcomes.

Whilst people and staff did not raise any concerns in this area, we identified shortfalls relating to people’s specific medical conditions, the management of distressed

behaviours, medicines management, continence care and nutrition and hydration which posed a risk to people’s health and wellbeing.

Staff gave us examples of how being at the home had improved people’s health and wellbeing.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

Records did not always demonstrate how staff followed the principles of the MCA. Some care records contained conflicting information in relation to people’s capacity. This meant there was a risk people received care which did not uphold their rights.

DoLS applications had been submitted to the local authority for authorisation, if people’s plan of care amounted to a deprivation of liberty.