6 December 2022
During an inspection looking at part of 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.