We inspected the service on 6 January 2016 and the visit was unannounced.
At the last inspection on 10 November 2014 we asked the provider to take action to make improvements. We asked them to improve their practice in relation to the arrangements for monitoring the quality of the service and delivering improvement. We also asked the provider to improve their practice in relation to obtaining people’s consent to care. Following that inspection the provider sent us an action plan detailing what they were going to do to make improvements. We found that although improvements had been made to monitoring the quality of the service, the provider had still not fully considered people’s consent in line with the Mental Capacity Act 2005. You can see what action we told the provider to take at the back of the full version of the report.
The Elms Residential Home provides residential care for up to 18 older people. There were 18 people using the service at the time of our inspection, the majority of whom were living with a dementia-type condition. The accommodation was provided over two floors and there was access to the upper floor via a passenger lift or stairs. There was a large accessible garden that people could use.
It is a requirement that the home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of our inspection there was a registered manager in place.
People told us that they felt safe. Staff were aware of how to keep people safe through the training they had undertaken and knew how to report actual or suspicions of abuse.
Risks to people had largely been addressed and documented but the records sometimes lacked detailed information for staff to follow. We found that people did not always have a call bell available to help them to keep safe.
The home and equipment were being regularly checked so that people were safe. However, some records were not always up to date to verify this. Some plans to evacuate people from the home if needed were not always complete.
Staffing levels were appropriate to keep people safe during our visit. Feedback from relatives and staff members suggested that staffing levels needed to be looked at during the night. Recruitment of new staff was robust and the registered manager had carried out checks on prospective staff before they worked for the provider.
People received the medicines that they needed. We saw that there were systems and policies in place to make sure medicines were being handled safely.
We saw that staff members had received regular training, including dementia training, which was important for the people they offered support to. However, we found that best practice in relation to dementia care and support was not always in place.
People were given choices regarding food but sometimes these were in ways that they could not understand.
People’s consent to care had not been fully considered. Where people may have lacked the capacity to make decisions for themselves, the provider had not made arrangements for appropriate mental capacity assessments to be undertaken. We also saw that decisions made in a person’s best interest had not been documented. We found that staff had undertaken training in the Mental Capacity Act 2005 but they did not show a good understanding of this legislation. We identified that these matters constituted a breach of the regulation where there service had failed to act in accordance with the provisions of the Mental Capacity Act 2005.
People enjoyed the food offered to them. However, where people were receiving a soft diet it was not clear whether this was a person’s preference or if the home had put this in place.
People had access to a GP when required and we found that people received regular support from a chiropodist and dentist.
People told us that the staff were caring. We saw that staff offered support in a kind way. However, we found that staff did not spend quality time engaging with people and focused mainly on practical tasks.
People’s preferences were detailed in their care plans and we found things that were important for people to be in place. For example, a person’s preferences for their bedding had been addressed by staff.
Records did not show how people had been involved in decisions about their care. Relatives had not always been invited to be involved in their family member’s care planning.
People were largely receiving the care they required in line with their care plans. For example, people were being assisted to turn to prevent pressure ulcers from developing. However, where soft diets were given, these had not been carefully care planned.
People’s care plans were being reviewed regularly to give staff up to date information about people. However, the reviews did not identify incorrect information.
People had mixed views on the activities being offered. We found that the planned activities did not all happen on the day of our visit.
People felt listened to and knew how to make a complaint if they needed to. The registered manager had dealt effectively with any complaints received.
The registered manager had audited the service regularly. However, the audits had not identified what we found on the day of our visit. For example, we found call bells were not available to some people.
Staff told us that they felt the registered manager was approachable and that they felt supported. We saw that the registered manager offered guidance and support to staff members.
There was a shared understanding within the staff team about what the service strove to achieve which was high quality care.
Relatives had mixed views about whether the provider had sought feedback on the service. Where it had been sought, the results of the quality assurance process had not been shared.
The registered manager was aware of their role and responsibilities and made the correct notifications to the relevant authorities.
We inspected the service on 6 January 2016 and the visit was unannounced.
At the last inspection on 10 November 2014 we asked the provider to take action to make improvements. We asked them to improve their practice in relation to the arrangements for monitoring the quality of the service and delivering improvement. We also asked the provider to improve their practice in relation to obtaining people’s consent to care. Following that inspection the provider sent us an action plan detailing what they were going to do to make improvements. We found that although improvements had been made to monitoring the quality of the service, the provider had still not fully considered people’s consent in line with the Mental Capacity Act 2005. You can see what action we told the provider to take at the back of the full version of the report.
The Elms Residential Home provides residential care for up to 18 older people. There were 18 people using the service at the time of our inspection, the majority of whom were living with a dementia-type condition. The accommodation was provided over two floors and there was access to the upper floor via a passenger lift or stairs. There was a large accessible garden that people could use.
It is a requirement that the home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of our inspection there was a registered manager in place.
People told us that they felt safe. Staff were aware of how to keep people safe through the training they had undertaken and knew how to report actual or suspicions of abuse.
Risks to people had largely been addressed and documented but the records sometimes lacked detailed information for staff to follow. We found that people did not always have a call bell available to help them to keep safe.
The home and equipment were being regularly checked so that people were safe. However, some records were not always up to date to verify this. Some plans to evacuate people from the home if needed were not always complete.
Staffing levels were appropriate to keep people safe during our visit. Feedback from relatives and staff members suggested that staffing levels needed to be looked at during the night. Recruitment of new staff was robust and the registered manager had carried out checks on prospective staff before they worked for the provider.
People received the medicines that they needed. We saw that there were systems and policies in place to make sure medicines were being handled safely.
We saw that staff members had received regular training, including dementia training, which was important for the people they offered support to. However, we found that best practice in relation to dementia care and support was not always in place.
People were given choices regarding food but sometimes these were in ways that they could not understand.
People’s consent to care had not been fully considered. Where people may have lacked the capacity to make decisions for themselves, the provider had not made arrangements for appropriate mental capacity assessments to be undertaken. We also saw that decisions made in a person’s best interest had not been documented. We found that staff had undertaken training in the Mental Capacity Act 2005 but they did not show a good understanding of this legislation. We identified that these matters constituted a breach of the regulation where there service had failed to act in accordance with the provisions of the Mental Capacity Act 2005.
People enjoyed the food offered to them. However, where people were receiving a soft diet it was not clear whether this was a person’s preference or if the home had put this in place.
People had access to a GP when required and we found that people received regular support from a chiropodist and dentist.
People told us that the staff were caring. We saw that staff offered support in a kind way. However, we found that staff did not spend quality time engaging with people and focused mainly on practical tasks.
People’s preferences were detailed in their care plans and we found things that were important for people to be in place. For example, a person’s preferences for their bedding had been addressed by staff.
Records did not show how people had been involved in decisions about their care. Relatives had not always been invited to be involved in their family member’s care planning.
People were largely receiving the care they required in line with their care plans. For example, people were being assisted to turn to prevent pressure ulcers from developing. However, where soft diets were given, these had not been carefully care planned.
People’s care plans were being reviewed regularly to give staff up to date information about people. However, the reviews did not identify incorrect information.
People had mixed views on the activities being offered. We found that the planned activities did not all happen on the day of our visit.
People felt listened to and knew how to make a complaint if they needed to. The registered manager had dealt effectively with any complaints received.
The registered manager had audited the service regularly. However, the audits had not identified what we found on the day of our visit. For example, we found call bells were not available to some people.
Staff told us that they felt the registered manager was approachable and that they felt supported. We saw that the registered manager offered guidance and support to staff members.
There was a shared understanding within the staff team about what the service strove to achieve which was high quality care.
Relatives had mixed views about whether the provider had sought feedback on the service. Where it had been sought, the results of the quality assurance process had not been shared.
The registered manager was aware of their role and responsibilities and made the correct notifications to the relevant authorities.