All inspections: Elmwood House Nursing Home

This was an unannounced inspection carried out on 5 January 2016.

Elmwood House Nursing Home can provide accommodation, nursing care and personal care for 48 older people and people who live with dementia. There were 42 people living in the service at the time of our inspection.

There was a registered manager. 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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from harm. People were helped to promote their wellbeing, steps had been taken to reduce the risk of accidents and medicines were safely managed. There were enough staff on duty and background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to care for people in the right way. This included being able to assist people to eat and drink enough in order to stay well. In addition, people had been supported to receive all of the healthcare assistance they needed.

The registered manager and staff were following the Mental Capacity Act 2005 (MCA). This measure is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards (DoLS) under the MCA and to report on what we find. These safeguards are designed to protect people where they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had taken all of the necessary steps to ensure that people’s rights were protected.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had received all of the care they needed including people who could become distressed and who needed reassurance. People had been consulted about the care they wanted to receive and they had been given all of the assistance they needed. Staff had supported people to express their individuality including pursuing their interests and hobbies. There was a system for resolving complaints.

Regular quality checks had been completed to ensure that people received all of the care they needed and people had been consulted about the development of the service. Staff were supported to speak out if they had any concerns because the service was run in an open and relaxed way. People had benefited from staff acting upon good practice guidance because it helped to ensure that they received care which reliably met their individual needs and wishes.

We considered our inspection's findings to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found:

Is the service caring?

People who used the service and their relatives considered staff to be respectful, kind and attentive. We saw that staff were courteous and polite in their manner when they were caring for people.

Is the service responsive?

We saw that people's individual needs for nursing and personal care were assessed so that they could be fully met. People were involved in making decisions about the care they received and they were supported to give informed consent whenever possible.

Is the service safe?

Staff had understood their roles and responsibilities to ensure that people were protected from the risk of abuse. People were protected against the use of unlawful or excessive control or restraint because the provider had made suitable arrangements. No one was having their liberty restricted at the time of our inspection visit.

Is the service effective?

We found that staff knew about people's individual personal and healthcare needs. People received the care they needed and wanted.

Is the service well led?

There were regular quality checks that helped to ensure that people received care in the right way. However, some of the checks completed of the accommodation had not identified a number of defects that reduced people's ability to live in a comfortable and pleasant setting.

During our visit we spoke with three people. We observed the care people received and looked at records.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.

We observed care and saw staff were responsive to people and interacted with them positively.

We saw from the care plans and observations people received care which was appropriate to their needs.

People told us the staff were caring and looked after them well. People said, 'They look after me and treat me well' and "Can ask for what you want.'

When we looked at the records we found there were gaps and they did not always accurately reflect the care people were being given or required. For example we saw some gaps in the records related to turning people who needed this level of support.

The provider had an up to date Statement of Purpose in place which detailed the care and service being provided.

We had concerns about consent and the recording of people's consent to care. Care plans were not signed by people to say they agreed with the care they were provided with. It was not clear from the records whether or not people had the capacity to consent.

We saw the provider had in place systems to assess the quality of care being provided and to ensure learning from incidences occurred.

Overall we observed people were supported by skilled and experienced staff who understood their roles and responsibilities.

We saw people were treated with dignity and respect and were supported to make decisions about their care.

We spoke with a person who told us the home 'Nice.'

We spoke with staff and they were able to tell us about how people liked to be cared for.

When we asked about the staff one person said, "Very nice."

During our visit we heard staff talking to people in a sensitive way.

People told us they were happy with the care they received and said that staff were very good. One person told us, 'Nothing is too much trouble.'

People told us they felt safe in the home and we found that staff knew how to protect them and what to do if an allegation of abuse was made.

People told us that they were happy with everything and said they felt confident to talk to the staff if they were not happy or wanted changes made.

We spoke with some visitors who told us their relative had lived in the home a long time. They said they were involved in the decisions about the support provided and added they were happy with the care and accommodation. They said they were always welcomed by staff and offered refreshments when visiting. They also told us they had not had to make a complaint about anything but felt confident that the registered manager would respond appropriately if they did.

A Doctor who was visiting at the time told us that the home was good at calling for medical assistance if and when required.

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: Elmwood House Nursing Home

All Inspections

5 January 2016

During a routine inspection

29 April 2014

During a routine inspection

5 September 2013

During a routine inspection

11 January 2013

During a routine inspection

8 March 2012

During a routine inspection

Reports under our old system of regulation