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Archived: Elm House Residential Care Home Requires improvement

The provider of this service changed - see new profile

Inspection Summary

Overall summary & rating

Requires improvement

Updated 22 January 2016

This inspection took place on the 28 August, 3 September and 1 and 5 October 2015. The inspection was unannounced.

Elm House Residential Care Home is registered to provide accommodation for 40 people who require support and care with their daily lives. The home is located in the town of Nantwich close to shops, public transport and other local amenities. The premises provide purpose built accommodation in 38 single bedrooms and one double bedroom. It is a two storey building and people live on both floors. Communal facilities include bathrooms and WC’s located around the home for convenient access. There are a number of lounges including a large sun lounge and dining area which overlooks the town centre and a hairdressing salon which is used by the visiting hairdresser. Access between floors is by a passenger lift or the stairs. The premises are set within pleasant gardens with an enclosed garden to the rear of the home. Car parking is available to the front and side of the building. On the first day of our inspection there were 31 people living in the home.

The home has 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.

When we carried out our last inspection of the home in July 2013 we found that the provider was meeting all the requirements for a service of this type.

Whilst we found that people were provided with care that was kind and compassionate, the home was not always being managed effectively. There were times when there were insufficient suitably qualified and competent staff on duty, to provide a safe service to the people who lived in the home.

We found that concerns and complaints raised by staff and visiting professionals had not always been responded to effectively, so management were not learning from past events, or taking effective corrective action to improve the service.

Although some people told us they felt safe, we found that management and staff had not always taken effective action to protect vulnerable people from abuse and neglect.

We identified breaches of the relevant regulations in respect of person-centred care, need for consent, safe care and treatment, safeguarding service users, good governance, and staffing. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas


Requires improvement

Updated 22 January 2016

The service was not always safe.

People told us that they felt safe and staff we spoke with were aware of how to recognise and report signs of abuse and were confident that action would be taken to make sure people were safeguarded from abuse. However, management had not responded effectively when allegations of abuse had been made, medication and risks were not always managed effectively and there were occasions when there had been inadequate staff on duty.

Recruitment records demonstrated there were systems in place to help ensure staff employed at the home, were suitable to work with vulnerable people.


Requires improvement

Updated 22 January 2016

The service was not consistently effective.

People told us that they were well cared for by staff who were knowledgeable and skilled. However, we found that staff were not always receiving adequate levels of support and supervision. The registered manager told us that they were responsible for the supervision of care team leaders but had not provided any since they started work at the home in May 2015

People were involved in planning their care to a certain extent but the provider did not always act in accordance with the Mental Capacity Act 2005 to ensure people received the right level of support with their decision making.



Updated 22 January 2016

The service was caring.

People were provided with care that was kind and compassionate.

People were treated with respect and the staff understood how to provide care in a dignified manner and respected people’s right to privacy.


Requires improvement

Updated 22 January 2016

The service was not always responsive.

Whilst people praised the staff and some reported receiving good standards of care we found examples where care had not always been provided in a person centred way.

Complaints had not always been investigated or responded to, or effective action taken to eradicate problems and prevent recurrence.


Requires improvement

Updated 22 January 2016

The service was not always well-led.

Systems and processes established to ensure compliance with the regulations were not always operated effectively so the health and well-being of the people who lived at the home was not assured.

People, who lived at the home told us that the registered manager was accessible, listened to them and involved them in decision making. A quality assurance survey completed in 2014 indicated that those who responded enjoyed a high degree of satisfaction with the standard of care and facilities and services provided.