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Care Services

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East Riding Care Home, Morpeth.

East Riding Care Home in Morpeth is a Nursing home and Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, caring for adults under 65 yrs, dementia and treatment of disease, disorder or injury. The last inspection date here was 23rd November 2019

East Riding Care Home is managed by Four Seasons Health Care (England) Limited who are also responsible for 8 other locations

Contact Details:

    Address:
      East Riding Care Home
      Whoral Bank
      Morpeth
      NE61 3AA
      United Kingdom
    Telephone:
      01670505444
    Website:

Ratings:

For a guide to the ratings, click here.

Safe: Inadequate
Effective: Requires Improvement
Caring: Requires Improvement
Responsive: Requires Improvement
Well-Led: Inadequate
Overall: Inadequate

Further Details:

Important Dates:

    Last Inspection 2019-11-23
    Last Published 2019-04-11

Local Authority:

    Northumberland

Link to this page:

    HTML   BBCode

Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

22nd February 2019 - During a routine inspection pdf icon

About the service: East Riding Care Home provides personal and nursing care for up to 67 people. On day one of the inspection 43 people were living at the service. The home has two floors and supports people who may be living with a dementia.

People’s experience of using this service: Medicines were not managed safely. We could not be sure people received their medicines as prescribed.

Staff told us there were not enough staff to support people in a timely manner. Inspectors had to look for staff on several occasions as people needed support.

The environment was not safe for its intended use. Maintenance checks had not been routinely completed and nurse call bells were tied up out of people’s reach. Staff were concerned about how they would evacuate people in the event of a fire.

There were concerns in relation to meeting people's nutrition and hydration needs.

Care records were not always accurate or up to date. Risks to people had not always been mitigated.

Management checks were not sufficiently robust to drive improvement.

There was limited evidence of a person-centred culture and visitors shared concerns around communication and management.

Staff had a caring nature and treated people with kindness however engagement and interaction was limited due to the numbers of staff on shift.

Activities were varied and people were supported to engage with the local community on days out.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: At the last inspection the service was rated requires improvement. (Report published 12 September 2018).

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good. During this inspection we found the required improvements had not been made.

Why we inspected: The inspection at East Riding Care Home was brought forward due to the receipt of information of concern. These included concerns around staffing, provision of care, nutrition, hygiene and premises. This inspection examined those risks and we shared the concerns with the local safeguarding and commissioning team. East Riding Care Home is currently within the local authority organisational safeguarding framework.

Enforcement: We identified two ongoing breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment and good governance. New breaches in relation to staffing and nutrition and hydration were identified. Please see the Action we told provider to take section towards the end of the report.

We are taking action against the provider for failing to meet the Regulations. Full information about CQC's regulatory responses to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made

significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept

under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and

27th June 2018 - During a routine inspection pdf icon

This inspection took place on the 27 June 2018 and was unannounced. We carried out a further visit to the home on 29 June 2018 to complete the inspection.

East Riding is a 'care home.' People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home can accommodate up to 67 people. There were 34 people living at the home at the time of the inspection.

The home was divided into two smaller ‘homes.’ Millview was located on the ground floor and accommodated those people who had general nursing and personal care needs. 'Wansbeck' was located on the first floor, for those people who had a dementia related condition.

We last inspected the home in August 2016. At that time, we found the provider was meeting all the regulations we inspected. We rated the service as good.

A registered manager was in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Following our inspection, the registered manager told us she was going to step down from her post, because her passion was “hands on care” and she wanted to return to care duties. The regional manager explained that they had advertised the post and the registered manager was going to remain in post until a replacement manager was found. The service was supported by senior management.

The service had been through a period of unsettlement. There had been a number of anonymous concerns raised in late 2017 and early 2018. The local authority was investigating these concerns and had placed the service into organisational safeguarding. This meant that the local authority was monitoring the whole service.

Prior to the inspection, the provider had agreed to a voluntary suspension of admissions to the service. At the time of the inspection, the suspension had been lifted, however, the local authority were monitoring all admissions to the home.

There had been a fire safety visit on 19 May 2018 by Northumberland Fire and Rescue Service who had deemed that some people were at risk in the event of a fire. There were shortfalls and omissions relating to the fire risk assessment and fire/smoke detection devices. The registered manager told us that these issues were being addressed. We also found that maintenance and servicing records were not always available or accessible to demonstrate that the premises and equipment were safe.

There were omissions in the recording of some people’s medicines. Individual guidance to inform staff about when medicines prescribed to be given only when needed, was not always detailed or person centred.

Most people, relatives and staff told us that more staff would be appreciated. Because of the previous suspension, occupancy levels were still quite low. Some staff raised concerns about staffing levels once occupancy levels increased. Due to the size of the service, it was difficult at times to find staff in ‘Wansbeck.’ The registered manager and regional managers were aware of this issue and were looking at possible solutions such as dividing Wansbeck into two smaller areas. We have recommended that the provider keeps staffing under review to ensure that sufficient staff are deployed at all times.

Prior to our inspection in late 2017 / early 2018, there had been two episodes of diarrhoea and vomiting followed by a flu outbreak. The registered manager told us that this had contributed to a number of people losing weight. We found that nutritional risk assessments were not always completed accurately and there had been a historic delay in referring two people to the dietitian. This delay corresponded to the time when there had been a number of concerns raised about the home and

2nd August 2016 - During a routine inspection pdf icon

East Riding care home is located in Morpeth Northumberland. The service provides personal care and nursing for up to 67 older people. The ground floor is called the Millview Unit and the first floor known as the Wansbeck unit, provides care for people with a dementia related condition.

The inspection took place on 27 July and 2 August 2016 and was unannounced. The inspection was carried out by one inspector. There were 54 people using the service at the time of the inspection.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was inspected on 14 and 15 Oct 2014 and we found they were not meeting the regulation in relation to the safe management of medicines. A focussed inspection carried out on 8 June 2015 found safety had been improved but the rating of requires improvement in the safe domain was not changed as to do so requires consistent good practice over time. At this inspection we found that medicines were managed safely.

Safeguarding procedures were in place and staff had received training in the safeguarding of vulnerable adults. Staff were aware of the procedures to follow and told us they had never had cause for concern. Safe recruitment practices helped to ensure that people were protected from abuse.

The safety of the premises and equipment was risk assessed and monitored on a regular basis. Individual risks to people related to health, safety and wellbeing were also assessed. These included risks related to falls, nutrition and skin damage for example.

We saw that the building was well maintained and clean. Staff were aware of infection control procedures and had received regular training. An item of equipment stored inappropriately in an en- suite bathroom was immediately removed and stored elsewhere. The manager acknowledged that storage of bulky items could be a problem and that alternative storage solutions were being considered.

Medicines were managed robustly and clear procedures were in place. Regular audits were carried out to ensure that medicines continued to be managed safely.

There were suitable numbers of staff on duty during the inspection. We found that due to the layout of the Wansbeck unit in particular, it was not always easy for staff to observe people. We discussed this with the registered manager who agreed to speak with staff to remind them that care must be taken to ensure that staff are effectively deployed in the unit to maintain close supervision.

The service was working within the principles of the Mental Capacity Act 2005 and there were suitable records in place. Capacity assessments were carried out and applications had been made to deprive people of their liberty where necessary, in line with legal requirements.

The health needs of people were supported. People had access to a range of health professionals and a GP visited to conduct a weekly 'ward round'. The GP was complimentary about the way staff responded to the health needs of people. The nutrition and hydration needs of people were assessed and monitored. People and relatives told us the food was very good and we found that alternative choices were readily available.

Staff were observed to be caring and considerate during the inspection. They responded promptly to the needs of people and did so respectfully. They demonstrated warmth and tenderness towards people, particularly those who appeared distressed. Staff were trained in end of life care, and a palliative care support team had been set up to support people and their relatives towards the end of life.

Person centred care plans were in place which were up to date and regularly reviewed. These included information related t

8th June 2015 - During an inspection to make sure that the improvements required had been made pdf icon

We carried out an unannounced comprehensive inspection of this service on 14 and 15 October 2014. A breach of legal requirements was found in relations to medicines management. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2010 - management of medicines.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for East Riding Care Home on our website at www.cqc.org.uk

We could not improve the rating for safe from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

We found that action had been taken to improve safety. Safe systems were now in place for the administration and recording of medicines.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

People and relatives spoke positively about the care provided by staff. One relative said, “I don’t think he would get better care anywhere else.” Staff spoke positively about working at the home and the support they received from the manager. Comments included, “I love working here, I would work here 24/7 if I could,” “It’s mint [great] here. The manager is mint and the residents are mint” and “It’s lovely here, staffing levels are appropriate.”

We spent time looking around the home and saw that it was generally clean and well maintained. New carpets were being fitted and painting and decorating had commenced. The manager told us however, that the decorators had been temporarily reassigned to another care home owned by the provider. This meant that there were still areas of damaged paintwork in places.

People, staff and relatives did not raise any concerns with staffing levels although they stated more staff would be beneficial. We observed that staff carried out their duties in a calm unhurried manner. We found that safe recruitment procedures were followed.

People, staff and relatives did not raise any concerns about staffing. They told us that more staff would always be appreciated; however, staff were able to meet people’s needs with the number of staff employed and deployed. We found that safe recruitment procedures were followed.

14th January 2014 - During an inspection to make sure that the improvements required had been made pdf icon

We found that the provider had made improvements in the essential standards which we inspected.

We spoke with 11 people and 10 relatives to hear their opinions. We also spoke with a Community Matron for Nursing Homes who was visiting the home. She informed us, “There’s been positive changes.”

People and relatives informed us that staff respected privacy and dignity. One person informed us, “They always knock on the door and draw your curtains.” A relative told us, “They’re very conscious of privacy and dignity…There’s also never any smells.” We considered that people’s diversity, values and human rights were now respected.

People were positive about the care and support they received. One person told us, "They’re very responsive to people’s needs…They respond in every way they can.” We concluded that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

19th April 2012 - During an inspection to make sure that the improvements required had been made pdf icon

People told us they were happy at the home. One person said routines were flexible and designed to suit her needs. They said "I go out with my family regularly and they come to see me here, I feel safe, they (the staff) are there if I need anything but most of the time I please myself what I do".

People said the staff were kind and caring, one person said "the staff here are lovely, nothing is too much trouble, they are very kind. I was not feeling well last week and they looked after me really well".

People said they had a choice of food at mealtimes and could choose to eat in the dining areas or their own room.

30th November 2011 - During a routine inspection pdf icon

People said they were happy with the care and support provided at the home. People said staff were "super" and "kind and considerate". Visitors to the home told us that staff were very patient when attending to people. They said staff kept them informed of changes to their relatives care and supported them through difficult times. Everyone we spoke with said that the home had improved over the past year. Relatives said people were given good amounts of food and drink and helped to stay clean. Some relatives had noticed that staff were busy and there appeared to be some shortages at times but they said staff attended to people promptly.

24th November 2010 - During an inspection in response to concerns pdf icon

The Local Authority have been carrying out reviews of individuals users of this service. They have confirmed that any disruption caused by improvements to the premises has been kept to a minimum. Individual people continue to be monitored by the Local Authority team and that team is meeting regularly with the provider.

1st January 1970 - During a routine inspection pdf icon

The inspection took place on 14 October 2014 and was unannounced. We carried out a second announced visit to the home on 15 October 2014 to complete the inspection.

The home was last inspected on 14 January 2014 when the provider met all the regulations inspected.

East Riding is a purpose built care home located in Morpeth. It accommodates up to 67 older people, some of whom have dementia related conditions. Accommodation is over two floors. There were 56 people using the service at the time of our inspection. People with general nursing and personal care needs lived on the ground floor which was known as the Millview unit. People who lived with dementia resided on the first floor which was called the Wansbeck unit.

There was a manager in post. She was not yet registered with the Care Quality Commission (CQC). She had sent in her application form and was awaiting an interview with a CQC registration inspector. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

There were procedures in place to keep people safe. Staff knew what action to take if abuse was suspected. Safe recruitment procedures were followed.

We saw that the premises were well maintained. We found however, that improvements were required with infection control procedures. The sluice machines for the cleaning of continence equipment were not operational.

We had concerns with certain aspects of medicines management, in particular with certain recording and administration systems. This was a breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the action we have asked the provider to take can be found at the back of this report.

Staff told us that training courses were available in safe working practices and dementia care. This training would help to meet the needs of people who lived at the home. Some relatives felt that a longer induction period was needed for staff. This was confirmed by one member of staff with whom we spoke. Other staff informed us that they felt supported and said that the training was adequate. The manager told us that she had developed a “flexible” approach to induction training which met the needs of individual staff who worked there.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure that people are looked after in a way that does not inappropriately restrict their freedom. The manager was submitting DoLS applications to the local authority to authorise. This procedure was in line with legislation and the recent Supreme Court ruling which had redefined the definition of what constituted a deprivation of liberty. The provider however, had not informed us of the outcome of these applications of which they are legally obliged to notify us. In addition, we found that further improvements were required in this area to ensure that “decision specific” mental capacity assessments were carried out in line with legislation.

We observed that staff supported people with their dietary requirements. A new chef was in post and people told us that there had been improvements in the quality of the meals.

Staff were knowledgeable about people’s needs. We observed positive interactions between people and staff especially on the second day of our inspection.

An activities coordinator was employed to help meet people’s social needs. Some relatives felt that more activities would be appreciated. The manager explained that they shared a mini bus with other local homes owned by the provider. The home was located on a steep hill and the manager said they had to rely on transport to support people to access the local community because it would not be safe to manually push people in wheelchairs up and down the hill.

A complaints process was in place. There was one ongoing complaint. The regional manager told us that if relatives were unhappy with the manager’s response; the complaint would be passed to them to investigate. The regional manager informed us that a face to face meeting was often arranged where concerns could be discussed further.

The manager carried out a number of checks on different aspects of the service. These included health and safety; dining experience; infection control; medicines and care plans. We found however, that these checks did not always highlight the concerns which we found for example, with medicines management. In addition, actions identified were not always carried out in a timely manner, such as the delay in plumbing in the sluice machines.

 

 

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