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Inspection report

Date of Inspection: 13 August 2014
Date of Publication: 6 January 2015
Inspection Report published 06 January 2015 PDF | 183.88 KB


Inspection carried out on 13 August 2014

During an inspection to make sure that the improvements required had been made

The inspection was carried out over a period of 12 hours by two inspectors. Elmwood is a small home which is registered for six people with learning disabilities. The home changed provider in November 2013.

There were six people who lived at the home on the day of inspection, one person was in hospital. They had learning disabilities and a range of needs including difficulties with mobility and communication. This meant they were not always able to tell us about their experiences.

The report is based on our observations during the inspection, talking with one person who used the service, five relatives, 10 staff who worked in the home and reviewing records. We gained information from healthcare professionals who were involved with the service, including the GP. We also talked with the manager/owner and deputy manager.

During this inspection we set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Safeguarding procedures were not robust. However, staff understood their role in safeguarding the people they supported.

The manager/owner of the home restricted staff from seeking advice from and making referrals to healthcare professionals, which led to delays in people who lived in the home receiving the care and treatment they needed.

Some areas of the home were not clean and hygienic. This put people at risk of harm. We spoke with the manager/owner about the lack of cleanliness in the shower room and toilet as well as a piece of equipment.

Medicines within home had not been properly accounted for.

Is the service effective?

People�s health and care needs were assessed by the manager/owner. People and their relatives (where this was appropriate) had not been involved in developing their care plans.

Some people who lived in the home were unable to communicate verbally. Care plans did not contain information about how to communicate with people.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people. A relative said, �The staff are lovely�.

We saw that staff knew people who lived in the home and were able to respond to their wants and needs.

Staff told us how they supported people to be involved and as independent as possible. We saw that most people who lived in the home were able to make choices and have some control over their lives. One person who lived in the home had no choice or control in their life and only left the home for a few hours each week.

People had not completed and had not been asked for their views about the home through a an annual satisfaction survey. However relatives had been asked to complete a questionnaire. Some people had not been involved in �Resident�s meetings�. People were at risk of not having their concerns and needs properly taken into account.

Is the service responsive?

Staff were unable to respond to people�s healthcare needs promptly as the manager/owner took responsibility for this. This had led to delays in gaining medical attention for someone who had been unwell.

We looked at the accident/incident record that the manager/owner had completed after a person had been admitted to hospital. The record did not detail the severity of the person's illness which meant professionals such as the person�s care manager did not have all the information they needed.

There had been delays in obtaining specialist equipment that people needed. We gained feedback from healthcare professionals who told us that they were involved with the home. However they told us that they had become involved because other professionals had instructed or arranged this and not because the home had recognised that they needed professional input and advice.

Is the service well-led?

None of the staff we spoke with had a good understanding of the mental capacity act. Staff members were clear about their role and responsibilities for reporting and raising concerns about abuse. All of the staff said that if they witnessed poor practice they would report their concerns.

The manager/owner of the home restricted what food was available within the home in order to prevent waste. This meant that staff had to ask for food supplies regularly.

PRN (as and when needed) medicines were not kept in the medication cabinet along with other prescribed medication. When a person was in pain, staff had to contact the manager to request pain relief. This meant that there were delays in people receiving the medicines they needed.

Laundry was not washed effectively to remove bacteria and this increased the risk of cross infection.

Some relatives told us that communication with the manager/owner was difficult and queries and concerns went unanswered. Two relatives told us that when they had mentioned cleaning tasks that were required, these tasks had been acted on quickly.

The manager/owner of the home had not notified the Care Quality Commission (CQC) of incidents that they had a duty to report. CQC had not been informed about Deprivation Of Liberty Safeguards (DOLS) applications, safeguarding concerns and the hospitalisation of one person who was seriously ill.