Elm Lodge Nursing and Residential Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care plans did not always include important information about people for example how their progressive disorder impacted them. People’s rooms were not always personalised and were very basic. Some people and their relatives were not aware of their care plan.

However, people and relatives were positive about how they were supported. One relative told us, “We have nothing but praise for all staff the way they look after our relative.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Leaders had an increased presence in the service and were working closely with commissioners to ensure that continuity of care was managed during an unsettled period. This was due to several changes in management and the implementation of new systems to drive improvement after concerns about risk were identified.

Staff told us that to ensure care continuity when someone’s needs changed, they would check care plans, hand over notes, daily records, alerts on the electronic care planning system and have verbal discussions. However, there was some confusion regarding handover processes which we discussed with leaders.

Care routine prompts were set up on the electronic care planning system when someone required regular support. For example, with repositioning, wound monitoring and post falls observations.

People told us they had support from the same staff. One person told us, “I know all carers who are helping me, some of them I know names some I just recognise faces.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service shared information and engaged with relatives by sending newsletters, informing them of concerns, inviting them to attend care plan reviews, sharing surveys and arranging meetings. However, two relatives told us they would like to be more informed about updates regarding their family member which we fed back to the provider.

People had a service user guide with important information and contact details. For example, details and processes for making a complaint.

Staff were available who could speak alternative languages, and we observed staff speaking with people in a slow and relaxed way to help make sure people understood what was being communicated with them. Menus had pictures on them and information was available in easy read format.

Staff did not always involve people in decisions about their care or tell them what had changed as a result.

We did not see evidence that complaints had been fully investigated, action taken or outcomes shared with people or relatives. This meant missed opportunities for learning and improving the quality of care provided.

People were not aware they could access independent advocacy.

However, the provider had processes in place for people to share feedback and ideas, or raise complaints about their care, treatment and support. One person told us, “If I don’t feel 100%, I tell them [staff] and just saying to somebody who will try to help, help tremendously, problem shared is problem half solved.”

Staff had gathered people’s views on the food and activities and discussed them during weekly meetings to make improvements.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Care plans prompted staff to consider referrals to professionals and in general included details on referrals made and guidance given. However, it was not always clear which professionals were involved and when referrals had been made. For example, one care plan stated that in September 2025 a staff member was going to refer a person to a specialist nurse for a review but there were no further updates. The service acknowledged this and had implemented a referrals log.

We received mixed feedback regarding access to health treatment. Some people told us they would like better follow up of their health conditions. However, others told us they had no concerns and one relative told us, “They quickly noticed [family members] legs swelling not long ago and called GP so now [family member] is on [appropriate medication] as well”.
We saw evidence that referrals were made to professionals including speech and language therapist and tissue viability nurse when required. Daily records included information about visits from other professionals. People had access to quiet spaces in the home as well as busier communal areas.
 

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The service did not always appropriately investigate or report safeguarding concerns for people who could not speak up for themselves.

It was also unclear how some people were being supported to follow their identified interests and pastimes, although this was an area the home was working to improve.

Staff received training in equity, diversity and human rights. This was observed in practice.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

End of life care plans were in place detailing personal wishes and any pre-arranged plans. Details of people’s legal representatives were recorded, and people had the opportunity to express their wishes around DNACPR.

Staff talked about the importance of providing warm, comforting care in line with people’s wishes when their health deteriorated.