Archived: The Elms Care Centre

Updated 4 June 2021

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 Care Act 2014.

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

The inspection was carried out by one inspector.

Service and service type

The Elms Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with four members of staff including a permanent and temporary care worker, a cook and the covering manager. We also spoke with the provider.

We reviewed a range of records. This included three people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at three staff files in relation to recruitment and staff supervision. We also reviewed additional policies and procedures, training records and quality assurance records. We also liaised with the local authority regarding their concerns and involvement.

Updated 4 June 2021

About the service

The Elms Care Centre is a residential care home providing personal and nursing care for up to 18 people aged 65. At the time of inspection five people were living at the service.

People are accommodated in one building split across two floors. There is a shared lounge and dining area. There is also a garden area people can access.

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

People were not safe. People did not receive care and support required to meet their needs or keep them safe.

Staff did not have the skills, knowledge or support to identify people’s health was deteriorating and did not seek medical intervention in a timely manner. This meant people were exposed to unnecessary risks and harm that may have been avoidable.

The service did not manage a COVID-19 outbreak effectively. Staff who were COVID-19 positive continued to work at the service despite having COVID-19 positive test results. Senior management and the provider knew this was happening. Consequently all 12 residents and most the staff contracted COVID-19.

The service was not well-led. There was not a registered manager at the service, and the provider had limited interaction with the service. This meant there was no clear leadership or oversight of the service, and limited opportunities to improve the quality of care people received.

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

Rating at last inspection (and update)

The last rating for this service was inadequate (published 19 December 2020).

At this inspection enough improvement had not been made/ sustained, and the provider was still in breach of regulations.

Why we inspected

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 coronavirus and other infection outbreaks effectively.

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about management of the COVID-19 outbreak. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with people’s safety and management of the service, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

The overall rating for the service has remained Inadequate. This is based on the findings at this inspection.

You can read the report from our last inspection, by selecting the ‘all reports’ link for The Elms Care Centre on our website www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Before our inspection activity had concluded the provider served notice on the five people living at the service. Clinical assessments of people were then undertaken on the same day as inspection due to concerns for people’s health and safety. This led to three people being moved to hospital and two people being moved to another home over a two-day period. Local authority staff were brought in to the service due to staff failings to provide the care and support people needed. The provider then cancelled their registration.

We have identified breaches in relation staff use of Personal Protective Equipment (PPE) management of COVID-19, assessing people’s care needs and seeking medical intervention in a timely manner, ensuring people received medicines safely, and how the service was managed and led at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This meant we would have kept the service under review, however, the provider cancelled their registration.

For adult social care services, the maximum time a service would be in special measures for would usually be no more than 12 months.