All inspections: Elmslea Care Home - Care Quality Commission

We carried out an unannounced comprehensive inspection of this service on 9 and 12 August. After that inspection we received information of concern in relation to the service.

As a result we undertook a focused inspection to look into the concerns. The concerns were about staffing levels and inaccurate rotas, lack of assessments of people’s capacity to make decisions for themselves, some policies and procedures lacking sufficient detail, a policy requesting people not to make ‘false allegations’, lack of safeguarding training and staff supervision. There were also concerns that health and social care professionals were not able to meet with people, and that people were coerced into doing activities the staff or registered manager had chosen for them.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Elmslea Care Home on our website at www.cqc.org.uk.

Elmslea Care Home provides care and accommodation for up to 11 people, some of whom have mental health issues or a learning disability. On the day of the inspection nine people were living at the service. Elmslea was in the process of changing the type of service they offer to supported living. Some people were already receiving support through the new service type.

The service had a registered manager in post. 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.

People told us they felt safe living at Elmslea and that staff respected their decisions and were kind. Staff were able to describe how they supported people with their individual choices. People told us they chose how to spend their time and felt safe communicating this to staff. Staff were able to give examples of when they had respected people’s decisions about daily activities. People were able to see health and social care professionals when they wanted to. The registered manager supported them to have their relatives or representatives present when important decisions were being discussed.

People’s records reflected what choices they had made on a daily basis. The registered manager was aware of the requirements of the Mental Capacity Act 2005 and had followed these in practice.

The registered manager and staff felt confident recognising and reporting signs of possible abuse. The provider had safeguarding and complaints policies in place which were discussed at residents’ meetings to help people understand them. However, the policies lacked detail about how to make a complaint or report abuse, and what steps would be taken to help ensure people were listened to and supported. The registered manager told us they would update them immediately.

Staff confirmed they felt well supported by the registered manager and saw them regularly. There were sufficient staff on duty to meet people’s needs.

The inspection took place on 9 July and 12 August 2015 and was unannounced. The reason for the gap was due to people being away on holiday.

Elmslea provides care and accommodation for up to 11 people, some of whom have mental health issues or a learning disability. On the day of the inspection 9 people were living at the service.

The service had a registered manager in post. 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.

People living in Elmslea required little assistance with personal care needs and were encouraged to be independent. People and staff were relaxed in each other’s company. There was a friendly and welcoming atmosphere. We observed staff and people using the service chatting and enjoying each other’s company. Comments included; “I don’t think there’s anything I’d change – I just like it how it is.” People told us they were happy living there with one person saying; “I like living here very much.”

People had their privacy and dignity maintained. We observed staff supporting people when needed and being kind and compassionate.

People and their relatives were very happy with the care they received from staff and said they were knowledgeable and competent to meet their needs. People were encouraged and supported to make decisions and choices in their day to day lives.

People were protected by safe recruitment procedures. There were sufficient staff to meet people’s needs and staff received an induction programme. Staff had completed appropriate training and had the right skills to meet people’s needs.

People had access to healthcare professionals to make sure they received appropriate care and treatment to meet their health care needs such as diabetic nurse and GPs. Staff acted on the information given to them by professionals to ensure people received the care they needed to remain safe.

People’s medicines were managed safely. Medicines were managed, stored, given to people as prescribed and disposed of safely. People who self-medicated received assistance from staff and risk assessments were in place. Staff were appropriately trained and confirmed they understood the importance of safe administration and management of medicines.

Safeguarding of vulnerable adults training had been completed and staff knew how to report any concerns and what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People were supported to maintain a healthy, balanced diet. People were involved in planning, shopping and cooking meals. One person said; “The food is very good and you get a choice.”

People’s care records contained detailed information about how people wished to be supported. Records were regularly updated and people were involved in the planning of their care and support.

Staff confirmed the registered manager was supportive and approachable. Staff were happy in their role and spoke positively about their jobs.

There were quality assurance systems in place. Feedback to assess the quality of the service provided was sought from people and their relatives. Audits were carried out to help ensure people were safe, for example environmental audits were completed.

On the day of our visit we were told that there were nine people living at Elmslea Care Home. We spoke with seven people and four staff members, which included the home's owners, one of which being the registered manager. We looked at two people's care files in detail, observed care and reviewed information provided to us by the owners.

Staff told us about and demonstrated how they respected people's dignity. We observed this during our visit with staff knocking on bedroom doors before entering and people being issued with a key to their bedroom when they moved in to the home.

People we spoke with who were living at the home said that their care and welfare needs were being well met. Comments included: 'I am going on holiday soon, to Great Yarmouth and the Norfolk Broads', 'This is a happy and caring place' and 'We do lots of things, including college courses, voluntary work and in-house shows.'

People confirmed that they felt safe and supported by staff at Elmslea Care Home and had no concerns about the ability of staff to respond to safeguarding concerns.

People informed us that staff met their needs in a timely manner. Everyone we spoke with was confident in the ability of staff to provide the care needed. Comments included: 'I think there is enough staff'; and 'The staff are really helpful.'

People were made aware of the complaints system. This was provided in a format that they could use and understand.

We conducted an unannounced visit to Elmslea Care Home on 28 May 2012 as part of our programme of planned inspections.

People told us, "it's a happy, friendly home"; "it's a very good home" and "I think this is a very nice home and feel proud to be here and do anything to help". We saw that people came and went as they wanted, used the telephone to make health care appointments and were able to decorate their room and lock their door as they wished. There were many examples of how their independence was promoted.

There were also examples of restrictions in use at the home. People told us that hot drinks could only be prepared at set times of the day and part of the home should not be visited after 9.30pm. We saw a formal approach to people serving lunch. People were consistent in what they told us about what they could, and could not, do at the home.

People talked about the large choice of activities available and how hard the providers had worked toward making those activities available for them. These included voluntary work, sport, helping in the community, dance and skills improvements, such as reading. We saw how much pleasure a writing group were having, with much laughter and excitement as different challenges were met. We saw that one person's goal was achieved during our visit, that being to cook for a lot of people. However, there was also some negative comment, one example, was about working at a farm. This was also mentioned in a questionnaire survey the home had undertaken.

People appeared to be comfortable and confident in the presence of the staff and we saw them come to the provider/manager with questions and information. None of the six people we met mentioned any specific staff member but the providers were repeatedly mentioned as people to whom they would go.

People told us about the arrangements for maintaining their health, such as GP and dental visits. They liked the fact that the home was well situated in the town. Three people mentioned this as the best thing about the home. We were told that staff support was always available for health care appointments and, where a condition was of concern, the home had ensured health care was available.

All but one person told us that they felt safe at the home. However, the manager and one member of staff talked of investigating allegations of abuse themselves, rather than following the protocol of contacting the Local Authority safeguarding team, or care managers, for them to take the lead, or offer advice, in such matters. The home's whistle blowing policy also stated that the provider would investigate any concerns, which they should not, in line with recognised guidance.

Staff received training and supervision of their work so that they were knowledgeable in how to support people. People told us that they sometimes received the training as well.

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

Archived: Elmslea Care Home

All Inspections

20 June 2016

During an inspection looking at part of the service

9 July & 12 August 2015

During a routine inspection

28 May 2013

During a routine inspection

28 May 2012

During a routine inspection

Reports under our old system of regulation