Archived: Elgin Rest Home

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw people who used the service treated with respect and dignity by the staff.

People told us they felt safe. Safeguarding vulnerable adults from abuse procedures were robust and staff understood how to safeguard the people they supported. The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, staff were able to describe the circumstances when an application should be made and knew how to submit one.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. The provider had procedures in place to deal with emergencies to ensure the safety and welfare of the people who used the service.

The physical environment was well maintained and supported people's privacy and promoted independence and well-being. The premises were clear from clutter and areas were safe to walk around.

Is the service effective?

People's health and care needs were assessed with them and their relatives where possible and they were involved in discussing any changes to their care plan on a monthly basis. Any diverse needs such as use of equipment and dietary requirements had been identified in people's care plans.

All the staff we spoke with had undertaken relevant training to support the knowledge required to operate safe practices and meet people's needs.

Is the service caring?

People were supported by kind and attentive staff. Feedback from people's relatives was extremely positive about the care given by the staff. A relative said, "If you ask for anything, it is always done."

People's preferences, interests, and life history had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People engaged with a range of activities in and outside the service. People knew how to make a complaint if they were not happy. We looked at the complaints policy and saw that complaints were dealt with quickly. People received personalised care and were supported to express their views.

Is the service well-led?

Systems were in place to regularly monitor the quality and safety of the service. People who used the service were satisfied with the quality of the care they received. Staff, relatives and people who used the service felt involved in the service and contributed to how improvements could be made.

People told us that they were happy with the care and support they received from staff. They told us that they were treated well and that they could make choices about their care. We saw that people's views about their care and how the service was managed were obtained and acted upon.

We saw that care was planned and delivered in a way that met people's individual needs and took into account their wishes and preferences. People were supported to attend doctors and hospital appointments as part of managing health conditions and maintaining their overall health. Risks to people's safety and welfare were assessed and well managed.

We found that improvements had been made to the arrangements for protecting people against the risks of infections. Areas of the home we viewed were clean and free from unpleasant odours. There were arrangements in place for daily, weekly and periodic cleaning tasks. These arrangements were regularly audited to ensure their effectiveness.

People told us that there were enough staff available to support them. We saw that there were arrangements in place to ensure that there were appropriate numbers of suitably qualified staff to meet the needs of people who used the service.

The service was well led and managed. There were arrangements for testing the quality and safety of the services provided.

We found that improvements were required to ensure that people received safe and appropriate care which met their needs and took into consideration people's choices and wishes. Care was not planned and delivered in line with the needs of people who used the service.

Improvements were required to protect people from the risks of infection. Areas of the service were not clean and there were ineffective arrangements for minimising the risks of infection.

There were not always sufficient staff available to meet the needs of people who were using the service.

There were ineffective arrangements for monitoring and improving the quality and safety of the service.

Following our visit we met with the provider to discuss our concerns and to seek assurances that the required improvements to the service would be made. We will continue to monitor the service.

People said that there was a lack of food and activity choice and that they were not included in decisions about bedroom decoration. People also told us that they were left in wheelchairs for long periods throughout the day and we observed this during our visit. We also observed staff and saw that on occasions, people were not treated with enough dignity or respect in relation to privacy.

When we looked at the care plans we found that people received care and support that met their health needs. We also found that people's likes and dislikes were not always recorded.

We spoke with several people and to family members visiting their relatives. One relative said, 'They are excellent here. I can't fault them.'

We looked at safeguarding systems, staffing levels and training and found that people were protected because appropriate steps had been taken to prevent and detect abuse and to provide sufficient numbers of qualified staff.

In relation to medicines, when we looked at people's rooms, we found examples that showed that they were not being managed correctly and this put people at risk.

We also looked at how the home monitored the quality of service that they provided. We found a lack of audits and those that were present did not reflect a summary of findings and steps to take to achieve improvement.