Elm House Residential Care Home

Elm House is a residential care home providing personal and nursing care to up to 39 people. The service provides support to older people. At the time of our inspection there were 30 people using the service. The service can accommodate people in one purpose-built building.

People’s experience of using this service and what we found

Identified shortcomings in the quality of care in recent months had been recognised and improvements had been achieved by a new management team. The team recognised that while many improvements had been made, further progress was needed. This view was also shared by relatives of people living at the service.

Medicines were not always safely stored. We found a flammable prescribed cream in one bedroom that was not safely stored. The manager informed us subsequent to the inspection that action had been taken to address this and that ordinarily, all other creams were appropriately stored and risk assessed. Audits had been carried out on medicines systems and more work to drive up standards had been recognised.

People living at Elm House were happy with the support they received. People felt safe and were complimentary of the staff approach to them which was said was kind and caring.

The building was well maintained although it was identified that future refurbishment would be needed.

The management team had been transparent with other agencies including CQC and had introduced improved audits and set up more regular contact with families. The staff team felt more included in the running of the service and felt that a more inclusive culture had been created.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 20 February 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elm House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the time of our inspection there were 39 people living there. Many of these people were unable to give us verbal feedback about their views on the service but we observed them and their interactions with staff, during our inspection. We spoke with visitors to the home, so that we had their opinions to support our own observations.

The home requires a registered manager. 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. There was a registered manager in place.

We found that the home was a safe environment for people, who were supported by properly recruited staff who administered their medication correctly and who followed the policies and procedures of the provider. However, people told us that staffing levels were poor and we saw that the building was large and in two wings which, on two of the floors, were not connected. This could mean it was difficult for staff to support people it timely way.

People were treated without discrimination and their human rights were protected and promoted. Staff knew how to safeguard people from abuse and how to report any concerns about this or any other accident or incident.

We saw that all the staff treated people as individuals. The records we saw demonstrated that each care plan was individual to the person it was about. However, whilst the care plans were person centred, the daily records lacked detail as they just gave bland statements. People and their relatives told us they were involved in any reviews about their family member’s care plans.

The building had been purpose-built and it was safe and well maintained.

Staff were well-trained and supervised and had the skills and knowledge to deliver effective support to people living in the home. Staff understood the Mental Capacity Act 2005 and worked with other agencies to ensure that people had the right support. People were enabled to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were treated with kindness and compassion and staff involved them in decision-making about their day-to-day lives. They promoted people’s equality and diversity, gave explanations and information in a way that people could understand and supported people’s well-being and right to privacy.

The people who lived in Elm House could join in with various activities throughout each day.

We saw that the home worked well with other health and social care professionals to provide support to each individual person who lived in Elm House.

The service completed various quality checks and audits including questionnaires to people using it, their relative’s and health and social care professionals.

Further information is in the detailed findings below.