Elmwood Care Home

We observed most staff wearing personal protective equipment (PPE) correctly in line with current government guidance however some staff were not. During the inspection further reassurance had been sought and the manager confirmed they will investigate further. We saw evidence there was systems in place to prevent visitors from spreading infection on entering the premises and relatives we spoke with confirmed this, however this was not followed during the inspection.

We found the following examples of good practice.

Risks in relation to visitors had been assessed and action taken to ensure visits were still in place at the service and through video calls. Regular Infection prevention control (IPC) audits were undertaken. The home's infection prevention and control policy was up to date and in line with current guidance.

Staff had access to supplies of PPE and had received training to ensure they used this correctly. All staff had regular testing for COVID-19, and all had received their vaccinations. Staff were trained on how to keep people safe from the risk of infection.

Elmwood Care Home is situated in the Oakwood area of Leeds. The home has 36 beds, providing accommodation and nursing care for older people and people living with dementia. There were 25 people living at the service at the time of inspection.

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 told us they felt safe in their home. There were enough staff to deliver care safely, and staff received appropriate training and support. Staff had a good understanding of the signs of abuse and how to safeguard vulnerable adults and report concerns.

Overall medicines were managed safely; however we have made a recommendation about the management of some medicines.

Maintenance and premises safety checks had been falsely completed. This meant we could not be sure equipment was safe. The manager completed the checks robustly and confirmed safety. The manager told us they were investigating how this had happened to prevent a future reoccurrence.

There were appropriate recruitment processes in place to ensure staff were recruited safely and that they were suitable to work with vulnerable adults.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005. Staff were trained in the principles of the MCA and could describe how people were supported to make decisions; and where people did not have the capacity; decisions were made in their best interests.

We saw that people received support from kind and compassionate staff who understood their individual needs. Care plans were person centred and there was evidence of involvement from people and their relatives. People had plans in place to manage risks which were understood by staff.

People were supported to eat and drink safely and they told us they were able to choose what they wanted. If people did not like the options, kitchen staff were able to prepare alternatives from a well-stocked pantry containing fresh produce and ingredients. People’s weight was monitored and nutritional risk assessed appropriately.

People had regular and appropriate access to health professionals, and staff worked in partnership with health professionals to help people maintain their clinical wellbeing and manage their care needs.

There were systems in place for people to complain, and we saw evidence that complaints were responded to in line with the provider policy in a timely and appropriate way.

There was a clear leadership structure with the manager holding oversight of governance arrangements. Staff understood their roles and what was expected of them.

We saw that there was an effective quality assurance process, with a range of audits and monitoring systems in place to ensure quality of care was maintained and the environment of the home was safe.

We saw that the provider asked people what they thought of the service and that their views had generated actions to be taken by staff to make improvements.

Elmwood Care Home is situated in the suburb of Oakwood in north Leeds. Elmwood Care Home is a purpose built home with accommodation provided over three floors. The home can accommodate up to thirty six people.

At the time of our inspection the service had a registered manager. 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 commented on some staff being rough and ignoring them. We were made aware of a specific concern. We shared this with the registered manager who took appropriate action which they shared with us on the second day of our inspection.

People were mostly happy with the care they received from staff. We observed positive interactions between staff and people. Staff were able to describe people and how they wanted their care to be provided.

People did not always receive care that was planned to meet their individual needs and preferences. We saw decision specific mental capacity assessments on file, although these were not always signed by the appropriate person. Deprivation of Liberty Safeguards applications had recently been sent to the local authority. Further applications were in the process of being sent.

Staffing levels were adequate, although we found at busy times of the day, staff were under pressure to cope with the level of dependency in the service. The registered manager was assessing this every month. Staff received suitable support through their induction period. We saw ongoing support for staff through regular supervision and appraisals. Staff training completion rates were found to be high.

Medicines were mostly well managed, although we saw the system for recording the use of topical creams needed to be more robust. The registered manager was able to identify the action they were going to take to resolve this.

We saw the building was adequately maintained and risks to people were sufficiently managed. The service had an activities programme which people were engaged with. The records concerning people’s response to activities was not always appropriate.

Recruitment procedures we looked at were safe as the service carried out the necessary background checks against prospective staff members to ensure they were not barred from working with vulnerable people.

We found people were supported to access a range of healthcare professionals. This was recorded in care plans and people confirmed this. People’s nutritional needs were being met and we saw people were weighed regularly.

There was a system for handling complaints which we looked at. There was evidence to show the action taken in response to each incident.

We found there were sufficient quality management systems in place through a number of audits which were regularly completed. The service had a positive culture which reflected recent improvements and both people and staff were extremely positive about the care and support they received from the registered manager.

We found a breach in regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.

People who used the service or their relatives were positive about the care provided for themselves or their family member. They said they were treated well. Comments included:

'It's all very nice here.'

'Staff are kind.'

'Very satisfied thank you.'

We saw that staff were responsive to people's needs and requests for assistance. We saw that people who used the service were happy and comfortable with staff in their interaction with them.

Staff told us that people received good care. They were able to give examples of how they treated people as individuals with thought for their respect and dignity.

'I am so impressed, very caring and responsive to Mum's needs.'

'I am exceptionally happy and satisfied with everything here.'

'Staff are lovely, so kind, caring and patient.'

'Very good nurses, keep us well informed.'

We spoke with six members of staff who were all able to give examples and explain how they respected people's dignity, privacy and confidentiality. They spoke of the importance of treating people as individuals.

However, we found that some staff practice did not always respect the dignity of people who used the service and the care records of people who used the service needed some improvements. This would ensure people received care and support that met their specific needs.

People who used the service and their relatives said the home and bedrooms were suitable, clean and warm enough for them. Comments included:

'Very good standards of cleanliness.'

'Always spotless.'

'I have a lovely room, lovely view, all nicely set out.'

People were cared for, or supported by, suitably qualified, skilled and experienced staff. There were robust systems for recruitment of staff.

Comments and complaints people made were responded to appropriately.