18 May 2015 and 26 June 2015
During a routine inspection
This was an unannounced inspection which took place on 18 May 2015. A further announced inspection took place on 26 June 2015 at one of the Bury Metropolitan Borough Council offices. This was to look at the staff recruitment procedure and examine several staff recruitment files.
Elmhurst Residential Care Home is situated close to the local shops and facilities of Whitefield. There is a nearby bus route for Bury and Manchester. The home is run by Bury Metropolitan Borough Council and is registered to care for up to 27 people. Care is provided permanently for one person who has been resident at the home for several years and for people who require respite, short term, emergency or day care. On the inspection day of 18 May 2015 there was one person in permanent residence and 17 people receiving short term care.
We last inspected the home on 21 May 2013. At that inspection we found the service was meeting all the regulations that we reviewed.
We were notified prior to our inspection that the registered manager was on long-term absence. 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. A recently appointed interim manager was overseeing the management of the service.
During this inspection we found breaches in the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. You can see what action we have told the provider to take at the back of the full version of the report.
We found the system for managing medicines was not as safe as it should have been. The provider did not ensure the proper and safe management of medicines and did not ensure that sufficient quantities of medicines were available to meet the needs and safety of the people who used the service.
We found that harmful cleaning substances were not kept securely locked away. This placed the health and safety of people who used the service at risk of harm from hazardous substances.
We saw that people were not always provided with appropriate support or supervision when their meals and drinks were being served. This placed their health and welfare at risk of harm.
Meals were provided by an independent provider, who since February 2015 had established a Community Café within Elmhurst, known as the bistro. We were made aware that suitable and nutritious food was not routinely available ‘out of hours’ as the bistro was closed after 7pm each night. We recommend that the provider looks for a best practice solution to ensure that suitable and nutritious food is available between meals, particularly during the evening and night time hours.
We were made aware that the cook from the bistro had not received any specific training in relation to special diets. We recommend that, to help ensure the health and well being of people is protected, the provider looks for a best practice solution to ensure suitable training is provided for the cook.
We were told that people who used the service were not allowed to use the toilets situated close to the bistro. Staff told us that this sometimes caused distress and also did not protect people’s dignity. This was because some people needed to use the toilets quickly or were incontinent if they did not get to another toilet in time. We recommend the provider looks for a best practice solution to ensure that people who use the service are made aware that they can use the two toilets situated close to the bistro. This will help to ensure their dignityis protected by ensuring that all communal toilets are available for their use at all times.
We found people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. We saw that staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.
People who used the service told us they felt the staff had the skills and experience to meet their needs. People were happy with the care and support they received and spoke positively of the kindness and caring attitude of the staff.
We saw there were risk assessments in place for the safety of the premises. All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection.
Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply.
People’s care records contained enough information to guide staff on the care and support required. The care records showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk.
We found the provider understood the requirements of the Mental Capacity Act 2005 (MCA) and
the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.
Staff we spoke with had a good understanding of the care and support that people required. We saw people looked well cared for and there was enough equipment available to promote people’s safety, comfort and independence.
To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of the running of the home and there were opportunities, such as questionnaires and meetings, for people to comment on the facilities of the service and the quality of the care provided.