People's experience.

The service was previously rated as ‘good’. This inspection found that the service retained its rating of ‘good’ in all areas. This means that people using the service received an effective service which was responsive to any changing needs. We found the service was managed safely and people were treated with care and respect. The good quality of care had positive outcomes for people using the service. More information is detailed the full report.

The service had a registered manager in place. 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.

Rating at last inspection:

Good (report published 14 September 2016)

Why we inspected:

We previously published our inspection in September 2016. It is CQC methodology to re-inspect ‘Good’ providers within a 30 month timescale. This inspection was completed as planned. We received information of concern from the Food Standards Agency (FSA). At our inspection we checked these concerns and found the provider was making progress from issues identified from the FSA report and found people were not placed at risk.

Follow up:

No concerns were raised within this inspection. We will therefore aim to re-inspect this service within 30 months. We will continue to monitor the service through the information we receive.

Easterlea Rest Home provides accommodation, personal care and support for up to 18 older people. At the time of our inspection there were 16 people living in the home.

The inspection was unannounced and was carried out on 20 and 22 July 2016 by one inspector.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The home was last inspected in February 2015 when one breach of the regulations was identified in relation to ensuring people had privacy regarding personal care. The provider sent us an action plan telling us how the service was being improved and at this inspection we saw theses actions had been completed.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect.

People told us they felt the home was safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.

The service was responsive to people’s needs and staff listened to what people said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.

People and when appropriate their families or other representatives were involved in discussions about their care planning. People were encouraged to provide feedback on the service provided both informally and through an annual questionnaire.

People felt the service was well led and were positive about the registered manager who understood the responsibilities of their role.

The quality of the care and treatment people experienced was monitored and action taken to promote people's safety and welfare. Staff felt they would be supported by the management to raise any issues or concerns and spoke positively about the culture and management of the home.

This inspection took place on 17 February 2015. It was unannounced.

Easterlea is registered to provide personal care and accommodation for up to 19 people. At the time of our inspection there were 17 older people living at the home. The registered manager told us none of them had significant medical conditions. A small number of people were living with the early stages of dementia, but the manager did not consider Easterlea to be a specialist dementia care home.

People were accommodated on two floors. Most people were in single rooms. Two people were sharing and told us they were happy to do so. Another double room had a single occupant. Shared areas of the home included a large lounge, dining area with small tables, and enclosed garden with a pond and paved area.

The manager had been registered with us since 2011. 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.

People were not always supported in a way that respected their privacy and dignity. We saw examples of care and support that did take people’s privacy and dignity into account but other examples that did not. Staff did not always use people’s preferred names in their handover records.

Care and support were provided with the person’s consent. Where people lacked capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005. However capacity assessments were not always specific to a single decision as required by the Act. We have made a recommendation concerning capacity assessments.

People were kept safe because appropriate procedures were in place and followed with respect to safeguarding adults. Staff received training in safeguarding and were aware of their responsibilities to identify and report any suspicions of abuse. Risks affecting people’s safety and wellbeing were identified and assessed. Staff took steps to reduce the impact of risks to people.

There were sufficient, suitable staff to support people safely and meet their needs. Staff followed processes to make sure medicines were stored, handled and managed safely.

People were cared for by staff who were supported to carry out their duties by a system of training, supervision and appraisals. However, supervision meetings between staff and the registered manager were not always recorded and examples of poor practice were not identified. We have made a recommendation concerning supervision and observation of practice.

People were supported to have a healthy diet which offered a choice of appetizing meals. Where people had specific dietary needs, these were catered for. People were supported to maintain their health and wellbeing by access to healthcare services including their GP, community nurses, dentists and opticians.

Staff developed caring relationships with people and helped them maintain their independence. People had opportunities to participate in decisions about their care and support. Staff were aware of their responsibilities concerning equality and diversity.

People received care and support that met their needs and changed when their needs changed. Care and support plans were focused on the individual and their preferences. They contained information about their life history and interests which was used by staff to support them in appropriate activities and hobbies.

People did not feel the need to make a formal complaint, but they were aware that they could and were confident any complaint would be dealt with properly.

The service had an open and inclusive atmosphere. People were involved in their care and support, and the registered manager was available to both people and staff. Checks and audits were in place to monitor the standard of service provided and the registered manager sought feedback from people, their families and staff by both formal and informal methods.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

On the day we inspected there were 15 people living at the home. During our inspection we spoke with three staff. We observed a calm atmosphere where staff were able to offer support whilst respecting people’s dignity and independence. The manager has an ‘open door policy’ whereby family and visitors could easily approach her and ask questions about the care and welfare of the person they were visiting.

We carried out an inspection in May 2013 when we had concerns as the systems and records were not being maintained or used consistently. We made a compliance action asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care. The provider wrote to us and told us what action they were going to take.

We carried out an inspection on 29 August 2013 to review the progress the provider had made in taking action to be compliant in the area where we had previously assessed them as non compliant.

We found that the provider, registered manager and deputy had taken steps to improve care planning and record keeping and had worked on embedding the new systems

On the day we inspected there were 16 people living at the home. During our inspection we spoke with three staff and four people who use the service. People we spoke with said that the staff “Are very caring”. One said “Nothing is too much trouble when they have the time” “They are nice but always very busy”.

Staff we spoke with said they received “Good support from the manager and had received training recently”, although could not recall what. We observed staff being respectful, asking if people would like support to leave the dining table, and being assisted to go to their rooms for a rest if they wished.

We carried out an inspection in January 2013 when we identified concerns with care planning, safeguarding, supporting staff and assessing and monitoring the service. We made compliance actions asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care. The provider wrote to us and told us what action they were going to take.

We carried out an inspection on 13 May 2013 to review the progress the provider had made in taking action to be compliant in the areas where we had previously assessed them as non compliant. We found that the provider had taken steps to improve care planning and had worked on embedding the new systems. However, the systems and records were not being maintained or used consistently.

During this visit we spoke with the management team, two members of care staff, the activity co-ordinator, five people that use the service and four family members. Comments received included "I could not wish for a nicer place to live in" and "the care staff are lovely". People told us that they felt safe in the home and were able to talk to their family members and the manager if they had concerns.We also spent time during our visit observing the interaction between staff and residents.

During the period of time between breakfast and lunch, there was no interaction between staff and residents. Only family members spoke with the people that used the service in the communal areas, except when a district nurse gave treatment to someone. In the afternoon, the activity co-ordinator spent time with different people engaging them in "scrap booking" (where individuals reminisce about days gone by and what is important to them).

We were able to speak with four people who live at the home, when we visited. They told us that they like living at the home and that the staff were helpful with nothing being too much trouble. The senior staff are easy to talk to and they like the manager's dog Gracie.

We observed lunch being served and how staff interacted with people and ensured choice. One person told us there were activities and games such as cards and dominoes and reminisence in the afternoons. The activity on the day of our visit was hairdressing.

Staff told us that they receive regular training, are supported by the management of the home and that they can speak with senior staff about any concerns they have about the running of the home.