24 April 2023
During an inspection looking at part of the service
People's experience of using this service and what we found
Systems and processes were in place to monitor the quality of the care provided. However, the systems to monitor medicines administration, accident and incidents and staff recruitment had not always resulted in areas for improvement being identified and acted upon in a timely manner. The manager took immediate action to remedy this.
The manager was aware improvements were required in the service, they had met with the provider and had produced an action plan covering the areas where improvement was needed and progress was being made.
People were protected from the risk of abuse. People and family members told us they felt safe, and staff treated them well. We received positive feedback from people using the service that demonstrated staff treated them with kindness and compassion.
People were supported by staff that were safely recruited. There was sufficient staff deployed throughout the service to meet people's needs. People were supported by staff that received appropriate training and support to fulfil their roles and responsibilities.
People were supported to maintain a balanced diet. Staff worked with health care professionals as and when required to promote people's safety and well-being.
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.
Opportunities were available for people and family members to share their views. Feedback received from people using the service, relatives and staff was used to drive improvement at the service.
The manager and provider were receptive to the inspection and took immediate action in response to the inspection findings.
Rating at last inspection
The last rating for the service was Requires Improvement, published on 03 November 2020. For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
The inspection was prompted through information shared by the local authority that improvements had been made at the service. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-Led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Elm Bank Care Home 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.