Elm Lea Residential Care Home

Updated 22 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 20 March 2018 and was unannounced. The inspection team consisted of two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience for this inspection had experience in care for older people.

The registered manager had completed a Provider Information Return (PIR). This is a form that asks them to give some key information about the service, what they do well and improvements they plan to make. We looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about.

During the inspection we observed the support that people received in the communal lounge and dining area of the service. As part of the inspection we spoke with the registered manager, two care staff, the chef and the housekeeper. We spoke with nine people using the service and two relatives to gain their feedback on the service they received.

We reviewed a range of records. This included four people’s care records including care planning documentation, risk assessments, nutrition and hydration information and medicine records. We looked at documentation that related to staff management and recruitment including two staff files. We also looked at records concerning the monitoring, safety and quality of the service.

Updated 22 May 2018

This inspection was carried out on 20 March 2018. The inspection was unannounced.

Elm Lea Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Elm Lea is registered to provide accommodation and personal care to 15 older people. The service is a detached house in a residential area, it has 14 bedrooms all of which have ensuite toilet and wash hand basin facilities. None of the rooms are used for double occupancy therefore the maximum number of people accommodated at the service does not exceed 14. There were ten people living there at the time of our inspection; a further person had recently been admitted to hospital.

At the last inspection on 23 and 24 November 2016, the service was rated Requires Improvement. At this inspection the service was rated Good.

At our last inspection in November 2016, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to the management of people’s ‘as and when required’ medicines, and, failure to ensure effective systems were in place to monitor the quality of the service. The registered manager sent us an action plan stating they would meet the regulations in November 2016. This inspection took place to check that the registered provider had made improvements to meet the regulations. We found that improvements had been made and the breaches had been met.

The service had a registered manager in post who had worked with the provider for a number of years. 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 registered manager was supported by a team leader.

People were not always offered the opportunity to participate in a range of activities to meet their needs and interests. We have made a recommendation about this.

People felt safe and were protected from the potential risk of harm and abuse. Staff understood their responsibilities for safeguarding people and followed the provider’s policy and procedure. Potential risks to people had been assessed and steps were taken to reduce any risks. The premises were well maintained and equipment had been regularly serviced to ensure it was in good working order.

There were enough staff deployed to meet people’s assessed needs. The provider operated safe and robust recruitment and selection procedures to make sure staff were suitable and safe to work with people. Staff were trained to meet people’s needs including any specialist needs. Staff were given feedback, support and guidance from their line manager, through regular supervision meetings.

People received their medicines safely as prescribed by their GP. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed regularly. People were protected by the prevention and control of infection where possible, with systems in place to ensure the risk of contamination were minimised. Accidents and incidents were monitored and managed effectively.

People’s needs and choices were assessed when they started using the service. People received care that was personalised to their needs. People were encouraged to maintain as much independence as they were able. People knew who to speak to if they were unhappy about the service. No complaints had been received.

People were encouraged to make their own choices about their lives. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were treated with dignity and respect by staff that were kind and caring. Staff knew people’s likes, dislikes and personal histories; this information was readily available within the persons’ care plan. People were supported to maintain relationships with people that mattered to them.

People were given choice at mealtimes and were able to access drinks and snacks throughout the day. People’s nutrition and hydration needs had been assessed and recorded. Staff and the chef met people’s specific dietary needs and support. Staff ensured people remained as healthy as possible with support from health care professionals, if required.

Systems were in place to monitor the quality of the service being provided to people. There was a range of checks and audits carried out to ensure the safety and quality of the service that was provided to people. People and staff were asked for their feedback about the service, with action taken if any suggestions or concerns were raised.

The registered manager understood their responsibility of registration with us and notified us of important events that occurred at the service; this meant we could check appropriate action had been taken.

The registered manager spoke passionately about providing a high quality person-centred service. They had developed working relationships with other services to promote and encourage best practice.

Further information is in the detailed findings below.