Archived: Elim Lodge Care Home

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

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

Is the service safe?

People were treated with respect and dignity and we observed caring and compassionate care by the staff. People told us they felt safe. People had their own care file and these contained an assessment of needs for example; social services support plan, life history, 'this is me', admission sheet and Mental Capacity Act 2005 (MCA) assessment, monitoring charts and contact with other professionals. The care files contained information about the way each person should be supported and cared for. Additional information included risk assessments to ensure people remained safe from harm.

There were activities for people to be involved in to give them stimulation and a choice about their welfare.

We saw that people had risk assessments in place which covered areas such as: weight monitoring, challenging behaviour, mobility, falls and medication to ensure people remained safe from harm.

We saw management checks of medication records and observed that the provider had appropriate systems to identify and record concerns. We were told about the specific training staff had received to handle medicines safely and checked this with the staff training records.

Is the service effective?

We spoke with visiting relatives and comments included, 'I take my relative out in their wheelchair and the staff here are brilliant. My relative is very happy here, it's a very nice place. She gets involved in the activities and last week she played the bowling and enjoyed the music session' and 'If my wife needs anything she gets it and she looks very well she has had her hair and nails done.'

We saw that meals times were relaxed; people ate their meals at their own pace and were supported by staff when required. We also saw that where people chose to eat their meals in the sitting room they were supported to do this by the staff. We observed one person saying, 'The food here is lovely.'

We spoke with the manager about the arrangement for people that may have need of further support in their decision making and advocacy services. The manager told us, 'The majority of the time this has already been pre-arranged by the placing authority services. However, people can ask for this service when they need it.' We saw that the service displayed the arrangements for advocacy services on the main notice board.

We saw records that confirmed staff received at least four supervisions and one appraisal a year. Records showed that staff had the opportunity to discuss for example; new skills training, work performance and personal development. This showed us the staff were supported, trained and had the appropriate skills and knowledge to be able to provide care safely to people who used the service.

Is the service caring?

We observed staff supporting people who used the service with the upmost care and respect. Staff appeared to know the people who they were caring for very well which assisted them in understanding a person's care needs.

We spoke with the manager about the arrangements for activities in order for people who used the service to be involved and feel stimulated. The manager told us that they did not have a full time activities co-ordinator and that care staff were responsible for in house activities. We saw that there was an activities register for each person that used the service and activities consisted of for example; sing along, hairdresser, bingo, poetry and singing.

The manager told us that some people in the service were known to have a dementia related condition. During our observations we saw staff helping people to eat and drink and provided positive interactions. We also observed staff taking their time to sit with people and speaking to them in a kind and compassionate manner.

Is the service responsive?

People regularly completed a range of activities in and outside the service. Different events and activities were available for people to take part in. We observed people who used the service visiting the hairdresser throughout the day and staff supported people in a calm and caring manner.

People who used the service told us, 'I sometimes like to go down the road to the seafront when the days are nice', 'I like the girls here they are lovely' and 'I get to go out sometimes and people here always look forward to their visitors.'

We also observed staff interacting with people in the sitting room by playing a game of draughts and 'connect four'. We also observed staff asking people if the television was too 'loud' or not loud enough which ensured their comfort and wellbeing.

People knew how to make a complaint if they were unhappy.

We also saw a comments book that was left in the main entrance for relatives and visitors to comment on their experiences with the service. Comments we looked at included. 'I am always made welcome and I enjoy talking to the staff. They seem happy and relaxed. My mum always seems happy keep up the good work.'

Is the service well-led?

The service had a developing quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

We saw that the provider had completed a residents' and families survey in March 2014 and an analysis of the results were completed and actions were noted and acted upon.

We also saw in the records that the provider had completed an employee survey in March 2014 to gain the views and comments from staff members. For example; are you given the opportunity to contribute your ideas and do you think the standard of the facilities could be improved. This meant that staff were given the opportunity to contribute to the effective running and quality of the service provision.

At this inspection in February 2014 we found that there had been improvements in how people were supported with their personal care and health care needs, so they were being cared for more effectively. We found that infection control practices had improved so there was less risk of harm to people from cross-infection.

We also found that staffing had increased, the premises had been tidied and some new floor coverings had been fitted in bathrooms but there had been no investment in any redecoration.

We found that the quality assurance system had improved to the extent that the new manager was carrying out daily checks on various areas of the service: the premises, staff training and food provision, but there was a lack of written evidence to demonstrate this. There had still been no satisfaction surveys issued to people that used the service or their relatives, and there had been no surveys issued to staff. Therefore we have extended the timescales for meeting this regulation.

The provider may find it useful to note that while some improvements to comply with regulations had been made, these improvements had been minimal and a commitment to ensure consistent compliance with regulations could only be tested over time.

People told us they gave their consent to care whenever staff asked if they wanted support. They said, 'The girls are lovely, they help me get up each morning". We saw people had given written consent to their care in care plans.

People told us they were satisfied with the care given to them. They said, 'The girls help me to get up, dressed and ready for the day', 'Oh these girls are very nice, they can't do enough for us' and 'I get a bath when I want one, the food is very nice with plenty of variety'. While people were satisfied with the care they received we saw in care plans that sometimes they did not receive the care they needed or that had been planned for them.

We found that although people expressed satisfaction with the hygiene standards in the home there were areas where infection control practices were poor and so people were at risk of infection from cross-contamination.

We found that the premises were safe but that they were old and tired and many areas had not been redecorated for some years. This meant that people did not live in as pleasant an environment as they could have lived in.

We found that there had been some unsettled episodes among the staffing team over several months and this had led to the registered manager resigning from their post. There was also insufficient staffing on duty to meet peoples' needs because dependencies were high with regard to mobility and people were often unsupervised as a result of this.

We found that there had been no implementation of the quality assurance and monitoring system within the service for over a year and so peoples' views were not sought or taken into consideration when making changes to the service to improve it. There was no evidence that the service had improved.