31 May 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was unannounced and took place on 9 April 2018. It was completed by one inspector.
The provider sent us a provider information return. This document provided key information about the service, what the service does well and improvements they plan to make in advance of the inspection visit.
We looked at all the information we have collected about the service. This included the previous inspection report and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law.
We looked at paperwork for three people who live in the service. This included care plans, daily notes and other documentation, such as medication records. In addition we looked at records related to the running of the service. These included a sample of health and safety, quality assurance, staff and training records.
During our inspection we observed care and support in communal areas of the home. We interacted with all the people who live in the home. Some people had limited verbal communication but were able to express their views by facial expression and body language. We spoke with four staff members, the registered manager, an assistant manager and the operations manager in private. Whilst on the inspection visit we spoke in private with two visiting professionals. We requested information from a range of other professionals, family members and staff. We received five responses from family members. In addition, we received written feedback from three staff members and four health/social care professionals.
31 May 2018
The Elms is a care home without nursing which is registered to provide a service for up to ten people with learning disabilities and some with physical disabilities. Some people had other associated difficulties such as being on the autistic spectrum. There were eight people living in the service with one in hospital on the day of the visit. All accommodation is provided within a detached two story building within a village style development.
At the last inspection on 7 January 2016 the service was rated Good overall.
This unannounced inspection took place on 9 April 2018. At this inspection we found the service remained Good overall. However, we noted that care plans were not always completely up to date and reviews including risk assessments had not been undertaken to the required frequency. As a result the responsive domain has been rated Requires Improvement.
Why the service is rated Good overall:
There is a registered manager running the service. A registered manager is a person who has registered with the Care Quality Commission 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’s safety was contributed to by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect people and who to alert if they had any concerns. General risks and risks to individuals were identified and appropriate action was taken to reduce them.
There were enough staff on duty at most times to meet people’s diverse, individual needs safely. The service had a stable staff team. The service had robust recruitment procedures. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.
The service remained effective. Staff were well-trained and able to meet people’s health and well-being needs. They were able to respond effectively to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s needs.
People were encouraged to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practise.
The service continued to be caring and responsive. The committed, attentive and knowledgeable staff team provided care with kindness and respect. Individualised care planning ensured people’s equality and diversity was respected. People were provided with some activities, according to their needs, abilities, health and preferences. Care plans had not been reviewed by management for some time. Some care plans did not contain the most up to date information and records indicated that some risk assessments were not always reviewed within stated timescales.
The registered manager was well regarded and respected. The quality of care the service provided continued to be reviewed and improved, as necessary.