Elm House Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. We found breach of the legal regulation (consent). We could not see any Mental Capacity Act assessments or best interests decision making in people's care plans, or around the use of covert medicines. There was a blanket approach to seeking consent from people's relatives for decisions, instead of checking whether the person could consent for themselves. However, the manager had applied to the local authority to make sure restrictions around people's care was legal and authorised (Deprivation of Liberty Safeguards). Staff understood the principles of consent and this was considered in people's care notes. Although care plans and reviews were up to date, some information was missing some was incorrect. For example, 2 people that were at risk of poor skin integrity did not have any written guidance for staff. The service was transferring from a paper based system to an electronic system. We found that monitoring of people's food and fluid had been missed. This was rectified when we fed back.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders and staff told us they could see care plans easily on new handheld electronic devices, and could input daily care notes onto these to see at a glance whether people received appropriate care. The provider planned to use an electronic system to input people's care plans and risk assessments, however this was not yet embedded. Some information to guide staff was missing or lacking in detail.

Although there was a new system for assessments and care plans, staff had not completed training on how to use it. The care plans and risk assessments we could see were not complete and lacked important information about how to care for people. We did not see any evidence of pre-admission assessments.

Staff completed relevant training such as nutrition and hydration. Staff said they monitored people's health although some records were missing.

There were relevant policies in place however it was not clear to what extent these were being followed.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us that staff asked them about their health and wellbeing and they could talk to staff about anything that was worrying them.

Staff did monitor outcomes such as people's weight, fluid and nutrition. However, staff told us that some had been missed recently due to moving from paper based to an electronic recording system.

Although staff recorded events such as when someone experienced a fall, it was not clear what the process was for monitoring this to take action such as referrals to the falls prevention service. The electronic system prompted staff to monitor people's health but this was not embedded.

We saw that staff sought consent prior to completing any caring tasks and this was noted in daily care notes. However, there was a blanket approach to the completion of consent forms. For example, for vaccinations consent was sought from relatives even if the person had capacity to consent for themselves.

Staff completed consent and mental capacity training and understood the principles.

We did not see any evidence of Mental Capacity Act assessments or Best Interests decision making in people's records. This was a breach of the legal regulation (consent). However, the manager had applied to the local authority to make sure legal authorisation was sought if someone was at risk of being deprived of their liberty.