Archived: Elingfield House

Elingfield House is registered to provider accommodation and personal care for up to 14 people some of whom are living with dementia.

One the day of our inspection there were 11 people living in the home. Five of the bedrooms can be used as shared rooms. At the time of the inspection three rooms were shared. There is a chair lift to the first floor. There is a large enclosed walled garden.

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 provider is in day to day control of the care home and as a sole trader there is no condition of registration to have a registered manager in post.

People were safe because the provider had systems in place to ensure staff were trained and understood how to recognise signs of abuse.

Recruitment was robust and appropriate checks were completed before people started working in the home.

There were enough staff working in the home to meet people’s needs. Staff received supervision and support in their role.

Medicines were managed safely. Staff were trained and their competency monitored.

Staff had the knowledge and skills to meet people’s needs safely and effectively. Staff received training that was relevant to their role.

Consent to care was sought in line with best practice.

People are supported to eat and drink. Food was freshly prepared and home cooking ensured people liked the dishes presented at meal time. People’s nutritional needs were assessed.

People had their health care needs met in a timely way by caring staff. People’s care needs were assessed and regularly reviewed.

Staff had built positive caring relationships with people living in the home. this was seen throughout the day in the conversations and discussion between care staff and people living in the home.

People were supported to express their views. Staff ensured that people have privacy and their wishes and preferences were respected.

The provider has developed and improved the service and responded to comments from people using the service to improve the home and the care provided.

On this occasion we found the provider had taken steps to ensure people had care plans and relevant risk assessments to guide staff in how to support people appropriately.

We gathered evidence against the outcome we inspected to help answer our one key question. Is the service effective?

Below is a summary of what we found. The summary is based on our looking at relevant records.

If you want to see the evidence supporting our summary please read our full report.

Is the service effective?

We found the service to be effective because people had a plan of care and relevant risk assessments where appropriate. These were reviewed regularly and changes to people's care needs were reflected in the reviews and in additional care plans.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking to people who use the service, their relatives, the staff supporting them and looking at records.

Is the service safe?

We found the service to be safe. People we spoke with told us that they did not have any concerns about safety. One person told us 'I feel very safe here.' The manager was knowledgeable about the Mental Capacity Act 2005 and the Deprivation of Liberty safeguards (DoLS). They told us that everyone currently living at the home had mental capacity. We saw that senior staff had attended DoLS training in May 2014.

Systems were in place to ensure that managers and staff learnt from events such as accidents and incidents, complaints and concerns.

We found the home to be clean and tidy, and there were effective infection control systems in place.

Is the service effective?

We found that the service was effective in meeting people's needs. One person we spoke with told us their health care needs were assessed with them, and they were involved in writing their care plan.

People's care plans and risk assessments were updated regularly or when people's support needs changed. Care plans had associated risk assessments in place. However, we saw that on some care plans, some risk assessments had been ticked as being completed, but we could not locate these in people's records. We also found one care plan that had not been updated when a person's eating and drinking needs had changed. We discussed this with the manager and a senior member of staff. There was some uncertainty about this and we were told that this would be reviewed.

We saw that people had been referred to healthcare specialists, such as occupational therapists or speech and language therapists to enable their particular needs to be met.

We saw the provider had arrangements in place to listen to what people had to say about the service such as satisfaction surveys. Where comments had been made to suggest improvements, we saw that the provider had responded to this. For example, they had arranged a regular time for relatives and residents to meet to discuss the service provided and this was advertised on a notice board in the home.

Is the service caring?

We found that the service was caring. We saw that care staff were kind and caring when supporting people with their everyday needs. For example, when assisting a person to eat their lunch staff talked to them and did not rush them through their meal.

We observed how staff interacted with people throughout the day and saw that they did so with kindness and respect. Staff were attentive and respected people's dignity. We spoke with people being supported by the service who told us 'They do look after us. I have no complaints' and 'I like to come back here on respite. It's very good.'

Is the service responsive?

We found that the service was responsive to people's needs and concerns. People knew how to make a complaint if they were unhappy and we saw that complaints were responded to appropriately.

We saw that when people's needs changed, the service responded in a timely way and communicated this to staff and other agencies.

The service worked well with other agencies and services, such as district nurses and GPs, to ensure that people received appropriate care and support.

During our inspection we observed that each time a call bell was rung, the staff responded to it immediately. One person told us that staff responded promptly to requests for help. For example, they said that staff were 'Always very helpful' and 'They're marvellous.'

Is the service well led?

We found the service to be well led. People told us that the manager 'Can not do enough for us'. Staff told us that the manager was 'Very supportive' and 'They do the assessments and let us know what people's needs are.'

The service had a quality assurance system in place for areas such as fire safety, infection control and general health and safety. We saw maintenance records that showed that any identified issues, or opportunities for improvement, were addressed promptly.

Staff meetings took place which enabled staff to discuss and plan improvements within the service. Staff told us that they were clear about their roles and responsibilities. They told us that they received training which supported them to carry out their roles. However, we saw records that showed not all staff had received the training they needed.

We looked at four staff recruitment records to check that all relevant documentation had been obtained before people started work at the service. We found that one staff member's file contained only one reference, but all other recruitment records were complete.

During our visit we observed good communication between staff and people who used the service and people were spoken to in a respectful manner. People who used the service told us that they were happy living at Elingfield House and that they had no concerns about how their personal care needs were met.

Risk assessments were linked to people's support plans. We saw that not all risk assessments in place corresponded with these plans. We also saw that risk assessments and support plans were not reviewed and updated monthly as stipulated in the home's own policy. This meant that information recorded may not reflect the current needs of each person.

People who use 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.

Staff commented that although the home's management were approachable, they were not always receptive to discussion about ideas on how the service runs.