• Care Home
  • Care home

Elmwood Residential Home Limited

Overall: Requires improvement read more about inspection ratings

Swan Hill Road, Colyford, Colyton, Devon, EX24 6QJ (01297) 552750

Provided and run by:
Elmwood Residential Home Limited

Latest inspection summary

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Background to this inspection

Updated 28 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by 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.

Service and service type

Elmwood Residential Home Limited is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Elmwood Residential Home Limited is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection the registered manager was in the process of deregistering and had left the service. However, they had returned on a temporary basis to oversee the home during a planned absence of the deputy manager until the end of December 2022. They deregistered on 19 December 2022, after our inspection visit, so we will refer to them as the registered manager throughout this report.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We sought feedback from the local authority at the East Devon weekly huddle meeting. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people and 2 of their relatives/friends. We also spoke with 10 staff including, the registered manager, senior care staff, care staff, kitchen and housekeeping staff and the maintenance person. We also spoke with the provider’s nominated individual (the nominated individual is responsible for supervising the management of the service on behalf of the provider), the providers accounts manager an agency chef and an agency carer.

We also spoke with a visiting GP and two community nurses.

We reviewed a range of records. This included two people's care records and a sample of medication records. We looked at a variety of records relating to the management of the service, including training records, incident records, recruitment records, quality assurance processes and various policies and procedures.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us

After the inspection the nominated individual sent us additional information about the service provided at Elmwood and actions they had taken in response to our feedback.

Overall inspection

Requires improvement

Updated 28 January 2023

About the service

Elmwood Residential Home Limited is a large detached period property in the town of Colyton in Devon with a large landscaped garden which people can easily access. It located 3 miles from Seaton and 6 miles from Axminster. They are registered to provide accommodation with personal care for up to 38 people with physical disabilities, long term medical conditions or memory loss. At the time of our inspection there were 34 people using the service.

People’s experience of using this service and what we found

People and relatives felt the service was safe. Comments included, “They look after us well. I haven’t got any complaints at all” and “I feel secure. I’m not afraid.”

People’s medicines were not always safely managed in line with the provider’s policy. We have made a recommendation about the management of medicines.

Staff had completed the providers mandatory training, but they had not always had their competency assessed and received refresher training. Staff had received safeguarding training and were aware of the different types of abuse.

Risk management was not always robust. In particular, monitoring people’s individual risks in relation to skin integrity and nutritional status. The management team needed to resume their monitoring of accidents and incidents to ensure staff had taken appropriate action and to look at any potential trends and minimise the risk of future incidents.

Fire safety and environmental safety needed to be improved to keep people safe. The provider took action at the inspection to reduce the risks to people.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider increased the staffing levels at night during the inspection. They told us the dependency tool they used to assess staff levels was being reviewed. Recruitment processes were robust.

The registered manager had resigned her position and left the home in October 2022 and had applied to deregister with CQC. The deputy manager had stepped into the managers role while the provider tried to recruit a new manager. At the time of the inspection the registered manager had returned to the home to cover while the deputy manager took a period of planned leave. The registered manager deregistered with CQC on 19 December 2022.

Since the registered manager had left in October 2022, managerial oversight had fallen behind at the home. This meant opportunities to drive positive change might have been missed, which could have resulted in improvement in the outcomes for people and reduce incidents.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection for this service was good (published 3 November 2018).

Why we inspected

We received concerns in relation to the management at the service and concerns raised by visiting health care professionals. As a result, we undertook a focused inspection to review the key questions of safe, effective and well led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elmwood Residential Home Limited on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.