Mount Elton Nursing Home

People’s experience of using this service and what we found

People and staff felt safe and all felt the service was a nice place. We found some shortfalls relating to staff not having a COVID risk assessment in place and no training for staff relating to COVID infection control and safeguarding training. However, following the inspection, the provider confirmed staff had received infection control training and there was a date sent for them to attend a safeguarding refresher training. They also confirmed risk assessments had been actioned following our inspection. All staff we spoke with had a good knowledge of both infection control procedures relating to managing COVID and identifying abuse and who they should report abuse too.

We inspected the service and were assured the service was managing infection control procedures relating to the risks of coronavirus and other infection outbreaks effectively. For example, we found personal protective equipment (PPE) was being worn as required, PPE was available for staff and staff knew how to use PPE correctly. Staff and visitors had access to hand hygiene such as hand sanitiser.

We found the following examples of good practice.

People supported to keep in touch with families. This had included outside visits and inside visits for those who were receiving end of life care.

There was a system in place to take people’s temperature on arrival and record contact details for test and tracing purposes.

Additional cleaning regimes were in place to ensure a high standard of cleanliness, paying particular attention to high touch areas such as door handles. The service was clean and odour free.

The provider was testing staff every week.

Why we inspected

We received concerns in relation to infection control procedures, staff recruitment systems within the service and poor governance systems. As a result, we undertook a targeted inspection to review the concerns raised within the key questions of Safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. We announced our inspection and requested information relating to infection prevention control policies, audits, contingency plans, staff training in infection control procedures and visiting policy during the COVID pandemic.

We found no evidence during this inspection that people were at risk of harm from these concerns.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mount Elton Nursing Home on our website at www.cqc.org.uk.

People’s experience of using this service:

Medicines records were not always accurate and up to date and two medicines were out of date. Guidelines were not always in place for topical creams. People were not always supported by staff who had checks undertaken prior to starting within the service or a risk assessment. The environment was not always safe, due to windows opening beyond the recommended safety guidelines, radiators that were not covered or risk assessed when they posed a risk of someone coming into prolonged contact with them. The sluice room which had chemicals within it was not securely locked.

The provider’s checks and audits had failed to identify shortfalls relating to the environment, medicines management, recruitment and shortfalls in records.

People were supported by staff who received supervision, training and an annual appraisal. Care plans contained important information relating to people’s mental capacity. Deprivation of Liberty Safeguard referrals were made when required. Incidents and accidents were recorded, and records confirmed any trends and actions taken.

People were supported by staff who were kind and caring although over lunch we observed people received care that was inconsistent due to people receiving support from various staff. Staff had a good understanding of how to respect privacy and dignity and how to promote independence.

Care plans contained important information relating to people’s individual needs. People had their care reviewed when required. Care plans contained people’s end of life wishes and the service liaised with professionals when required to meet people’s changing care needs. People felt happy to raise any complaints and these were logged including actions taken.

People and staff felt the management was approachable and it was a nice place to work. The service liaised with various stakeholders and shared information when required.

Rating at last inspection: Good (published February 2017).

Why we inspected: This was a planned inspection based on the previous rating. At this inspection we found the overall rating had changed from Good to Requires Improvement.

Follow up: We found one breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Mount Elton nursing home provides care for older people with nursing and personal care needs. At the time of the inspection there were 22 people living at the home. Accommodation is arranged over three floors. It has a lounge, a dining area, nurse’s station, a conservatory, kitchen and offices. There is a drive way at the front with parking and front lawns with a patio area.

There was a registered manager in post. 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 lived in a clean and tidy home although records relating to checks around the home needed improving. People had their views sought relating to the décor of the home. People were happy with the meal choices and could choose where they ate their meals. The home provided a social environment for visitors and was part of the community. Relatives were welcome to sit and spend as much time as they wished with their family members.

People’s care plans were detailed and personalised and contained informative risk assessments. However people at risk of their skin developing sores required confirmation in their care plan and charts of how often they should be turned. The registered manager took action during the inspection to update the care plan to reflect this information.

People felt safe in the home and received support from staff who had appropriate checks in place prior to commencing their employment. People’s care plans confirmed if people were unable to make decisions relating to their care and treatment and the principles of The Mental Capacity Act were being followed. People received their medicines when they needed then and from staff who were competent to do so.

People were supported by adequate staffing levels and staff supported people in a kind and caring manner. Staff received regular supervision and training to ensure they were skilled to meet people’s individual care needs although some staff’s knowledge around safeguarding and equality needed improving. Staff felt happy and supported by the management of the home.

People were supported to maintain relationships with friends and family. People were supported by staff who gave people choice and control in their care and support. People had access to activities and social events that were important to them. Activities included quizzes and songs, social morning, reading, exercises to music and poetry.

People felt able to make a complaint to the registered manager should they need to do so. People and relatives were involved in planning their care. The provider had quality assurance systems in place that identified areas for improvement. People, relatives and professionals views were sought so that improvements could be identified, feedback received was overall positive about the care provided and received.

We found people received care, treatment and support that met their needs and protected their rights. One person told us 'I am happy here. I have a choice of when to get up and retire. They are very flexible here'.

We found people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. One person told us 'I feel safe here. I have no complaints'.

The provider demonstrated that people were cared for in a clean, hygienic environment.

The provider was able to demonstrate that staff were provided with on-going training and that staff were supported by regular supervisions and yearly appraisals.

We found the provider had an effective system in place to monitor the quality of the service to ensure people received safe care.

The provider had an effective complaints system to meet people's needs.

The provider notified the Care Quality Commission of important events that affected the health, welfare or safety events of people who used the service so that, where needed, action could be taken.

We observed staff interacting with people who used the service in a respectful manner. However, we observed a staff member did not ask people who were sat in the lounge for their consent before putting on music on after lunch. When we asked one of the people in the lounge if they liked the music they said “no that’s not my kind of music I like classical music”.

We found people were protected from the risks of inadequate nutrition and dehydration.

We saw the provider had a policy on safeguarding people from abuse. The staff had attended training to ensure that people who lived in home were protected from the risk of abuse.

We saw the provider had an effective system in place to regularly monitor the quality of service that people received.

.We found from speaking to people who used the service and staff as well as looking at the training and supervision records that staff were trained and supported to deliver care to an appropriate standard.

We found the provider did not report important events affecting people’s health to the Care Quality Commission so that where needed, action could be taken.