Archived: The Elms Residential Care Home

Updated 9 September 2016

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 02 August 2016 and was unannounced. The inspection was carried out by one adult social care inspector and one inspection manager.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed this document to inform our inspection planning. In addition we reviewed information the Care Quality Commission (CQC) holds about the home. This included any statutory notifications, adult safeguarding information and comments and concerns. We contacted the commissioning bodies at the local authority to ascertain their views on the service the home provided. This information helped us plan the inspection effectively.

Information was gathered from a variety of sources throughout the inspection process. We spoke with five people who lived at the home, two relatives and two health professionals who visited the home to obtain their views about service provision.

We spoke with eight members of staff. This included the manager, three members of staff who provided direct care and four ancillary staff.

We looked at a variety of records. This included care plan files relating to four people who used the service and recruitment files belonging to four staff members. We viewed other documentation which was relevant to the management of the service including health and safety certification and training records.

Updated 9 September 2016

This unannounced inspection took place on 02 August 2016.

The Elms Residential Care Home is registered with the Care Quality Commission to provide accommodation and personal care for up to 41 residents. The home provides single bedded accommodation and has been adapted to meet the physical needs of people.

There was a registered manager in place. 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 service was last inspected on 14 November 2013. We identified no concerns at this inspection and found the provider was meeting all standards we assessed.

At this inspection carried out in August 2016, we received mixed feedback from people who lived at the home in regards to the quality of service provided. People told us they were generally happy with the overall service but were sometimes concerned about the staffing levels provided. Relatives, staff and health professionals said staffing levels were not always conducive to meet people’s needs.

We looked at staff rotas and considered the general needs of the people who lived at the home. There were a number of people with high support needs. These needs had not been considered at night time when staffing levels were decreased to two staff. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

Staff told us there was a shortage of staff at the home and agency staff were used as an interim measure. The registered manager said they were working proactively to manage the staffing situation and promoted consistency of care by using the same agency staff wherever possible.

Suitable recruitment procedures meant staff were correctly vetted before starting employment.

People were protected from risk of abuse. Procedures were in place to monitor incidents which had the potential to cause harm. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.

Suitable arrangements were in place for managing and administering medicines. Regular audits took place to ensure safe practices were maintained. Staff demonstrated a good understanding of the importance of safe handling of medicines and followed good practice guidance.

Risks to people were not always suitably managed. We identified risks within the environment and noted risk assessments and supporting documentation was not always present for all people who lived at the home. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

Premises and equipment were appropriately maintained. The environment was clean and tidy. A maintenance man was employed part time at the home to manage the safety within the building.

The registered provider had established links with health professionals to enable people to maintain good health. Care plans were developed and maintained for people who used the service. Care plans covered support needs and personal wishes. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required.

Feedback on the quality of food provided was positive from both people who lived at the home and relatives. People were happy with the variety and choice of meals available to them. People’s nutritional needs were addressed and monitored.

The registered manager had a training and development plan in place for all staff. We saw evidence staff were provided with relevant training to enable them to carry out their role. Staff told us they were provided with training which allowed them to carry out their tasks effectively. Ongoing training was provided for staff to enable them to carry out their tasks proficiently.

Staff had received training in The Mental Capacity Act 2005 and the associated Deprivation of Liberty Standards (DoLS.) We saw evidence these principles were put into practice when delivering care.

Staff were kind and caring. We observed positive interactions throughout the inspection visit. Relatives praised staff for their caring natures.

Relationships with families were encouraged. The service ensured visitors were welcomed to the home.

The service fostered an open and transparent culture. Complaints were dealt with in a timely manner and changes were implemented following complaints being raised.

Staff were positive about ways in which the service was managed and the support received from the management team. They described a positive working environment. Staff described teamwork as “Good.”

The registered provider had a range of assurance systems to monitor quality and effectiveness of the service provided. Feedback was gained from all parties as a means to develop and improve the service.

There was regular communication between management and staff.

You can see what action we have asked the provider to take at the back of the full report.