We inspected Elmdon House and spoke with the deputy manager and three care staff about the support they gave to people who lived at the home. Speaking with these people helped answer our five questions. Is the service safe? Is the service effective? Is the service caring? Is the service responsive and is the service well led? Below is a summary of what we found. This summary is based on our observations and evidence we found during the inspection. During our visit we were able to spend time and chat with the people who lived at the home.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
Elmdon House was suitable, safe and accessible for the people who lived there. Bedrooms were large enough for staff to be able to assist those people who required the support of a hoist when being moved. We saw the home was clean and well maintained with no unpleasant odours.
We saw risk assessments had been carried out for the service as a whole and for individual risk areas in people lives. There were appropriate certificates in place to confirm external checks of electricity, gas and emergency equipment.
The service was aware of their obligations in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLs). For one person the appropriate healthcare professionals and an independent advocate had been involved in a meeting to ensure any decisions made about the person's care were made in their best interests.
We looked at how medicines were managed within the home. We found one person was on medication to manage their behaviours. There was no protocol in place to inform staff when this medicine should be administered. We found the amounts in stock of medicines administered directly from the packet or box did not always correspond with medication records. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the management of medicines.
Is the service effective?
Care records contained sufficient information to support staff in consistently meeting people's needs. The plans were person centred and reflected people's individual needs. Where risks to health or well-being had been identified, risk assessments had been put in place to manage those risks. Where people had identified physical health needs there were guidelines in place for staff to follow to meet those needs.
We looked at staff training records. We found staff did not always receive the required training to support people effectively. We found some staff had not completed the necessary training which had the potential to place people at risk of receiving inappropriate care or support. We also found the provider did not have an effective system in place that made sure staff had regular supervisions to discuss any concerns, performance or training needs.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to supporting staff and making sure all staff are trained to the appropriate level.
Is the service caring?
People living at Elmdon House showed interest in each other and what others had been doing. When new staff came on duty people reacted positively and appeared pleased to see them. People approached the staff as they wanted throughout the day. People we spoke with appeared relaxed and comfortable in their surroundings. One person told us, "I am happy. I like it here."
People were well presented and wearing clothes that reflected their individual choices, age and preferences.
People living in the home chose the meals they wanted at weekly meetings. At lunch time staff assisted people to make choices. For example, people were shown a box of crisps and were asked to choose which flavour they wanted. This meant people were able to understand the choices they were offered.
Is the service responsive?
Records showed that other health professionals were involved in people's care. Staff told us they would contact the relevant health professional when needed and records confirmed this. Staff we spoke with were able to tell us about the individual needs and abilities of people and how they supported their mental health as well as their physical health.
Is the service well-led?
At the time of our visit the service had been without a registered manager since December 2013. The provider had put plans in place to provide managerial oversight during this period. A recently appointed deputy manager had been in post for two weeks and taken over some of the responsibilities of the registered manager. Staff we spoke with confirmed that after a difficult period, the service was now more settled. One staff member told us, "It is more relaxed." We have asked the provider to keep us informed of their progress in appointing a registered manager.
The service carried out a range of checks and audits to monitor the quality of the service provided. Staff meetings provided an opportunity for staff to discuss ideas for the benefit of people who lived in the home.