The inspection took place on 12 and 13 December 2016 and was unannounced. This meant the provider or staff did not know about our inspection visit.

We previously inspected Eastholme on 3 and 4 November 2015 and informed the registered provider they were in breach of two regulations: staffing and good governance. The provider subsequently submitted an action plan detailing how they would address these breaches of regulation.

Whilst completing this visit we reviewed the actions taken by the registered provider to address the above breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that the registered provider had ensured improvements were made regarding the governance of the service and a new manager had been recently appointed. We found this manager had made improvements to the service in the areas identified at the last inspection.

Eastholme is a residential home in Seaham, County Durham, providing accommodation and personal care for up to 4 people with learning disabilities. There were 4 people using the service at the time of our inspection.

The service did not have a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like directors, 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. We saw that, since the last registered manager had left the service the new manager had applied to register with CQC and had been given an interview date with CQC. The manager had their registration with CQC confirmed shortly after the inspection. The manager had introduced a range of improvements in the seven weeks they had been at the service.

People who used the service acted in a trusting manner with staff whom they knew well and relatives expressed confidence in the ability of staff to protect people from harm.

Staff we spoke with demonstrated a good understanding of how to keep people safe, both through formal safeguarding procedures if needed, and through adhering to risk assessments and support plans.

There were sufficient numbers of staff on duty in order to safely meet the needs of people using the service and to maintain the premises. All areas of the building including people’s rooms, bathrooms and communal areas were clean.

We found one instance of a pre-employment check via the Disclosure and Barring Service (DBS) not being appropriately acted on. The manager took prompt action to assess this risk and we saw other pre-employment checks, including references and ID checks, were in place.

The storage, administration and disposal of medicines was safe and in line with guidance issued by the National Institute for Health and Clinical Excellence (NICE). Specific plans were in place for people with ‘when required’ medicines.

There was regular liaison with GPs, nurses and specialists such as psychiatrists to ensure people received the treatment they needed. Professionals we spoke with confirmed staff communicated well with them.

Staff were trained in areas specific to meeting people’s needs, for example Positive Behaviour Support (PBS) training, and were also trained in areas the registered provider considered mandatory, such as safeguarding, fire safety, health and safety, medication administration, equality and diversity, human rights and infection control.

Staff were supported by regular supervision and appraisal processes as well as regular team meetings. The service manager had reviewed the amount of supervision meetings staff had received and ensured adequate future meetings were planned.

We observed people being supported to choose a range of meal options and make their own drinks. Staff were aware of people’s dietary needs and preferences.

Group activities included outings to outdoor activity providers and

The people that used the service at Eastholme had an autism spectrum disorder and therefore not everyone was able to tell us about their experiences. To help us understand the experiences people had we spent time watching what was going on in the service. This helped us to record how people spend their time, the type of support they get and whether they had positive experiences.

We found that members of staff were attentive to people's needs. People looked well cared for and at ease with the staff members who were supporting them.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People living in the home had limited verbal communication skills. People living in the home indicated that they were unwilling to communicate with us. However staff were seen to interact well and treated people with dignity and respect.

This inspection took place on 3-4 November 2015 and was unannounced. This meant the staff and provider did not know we would be visiting.

Eastholme provides care and accommodation for up to four people with autistic spectrum disorder or other learning disabilities. On the day of our inspection there were three people using the service.

The home had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run. At the time of our inspection visit, the registered manager was on sick leave and a temporary manager was in charge.

Eastholme was last inspected by CQC on 17 September 2013 and was compliant.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Accidents and incidents were not consistently recorded.

People were protected against the risks associated with the unsafe use and management of medicines.

Staff received regular supervisions and appraisals however staff training was not up to date.

Care records had not been updated with a person’s dietary needs.

The home was clean, spacious and suitable for the people who used the service.

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 Act 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. The application procedures for this in care homes and hospitals are 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 were being met. The provider was working within the principles of the MCA.

People who used the service, and family members, were complimentary about the standard of care at Eastholme.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

We saw that the home had a full programme of activities in place for people who used the service.

Care records showed that people’s needs were assessed before they moved into Eastholme and care plans were written in a person centred way.

The provider had a complaints policy and procedure in place and complaints were fully investigated.

The provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.

The service had links with the community and other organisations.

We found breaches of 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.