Archived: Elstree Lawns Care Home

Updated 3 June 2015

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 23 and 24 March 2015. The inspection team consisted of one inspector and one expert by experience. An expert by experience is a person who has personal experience of caring for someone who uses this type of care service.

We also had a specialist advisor, who was a qualified nurse to advise us about the nursing care provided. Before we visited, we reviewed the information we held about the home, including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us.

During our visit we spoke to nine staff, six people who used the service, six relatives and we spoke with an environmental health officer. We looked at four care records and three staff records. We looked at the quality of the nursing home environment and observed how staff cared for people. We looked at a range of policies, procedures and other documents relating to the running of the nursing home.

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who cannot fully express their views by talking with us. We observed people over lunch and found on the first floor there were not enough staff to meet people’s needs. Not all staff treated people with dignity and respect. People were not supported to eat where required.

Updated 3 June 2015

This inspection took place on 23 and 24 March 2015 and was unannounced.

Elstree Lawns Specialist Nursing Home is registered to provide accommodation and nursing care for up to 54 people. On the day of the inspection there were 31people using the service and a registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The provider used safe recruitment practices, staff had inductions and were supported with shadowing whilst developing skills. Supervisions and appraisals had not been completed but were being scheduled by the manager. Staff were aware of their responsibility to protect people from harm or abuse.

There was a newly appointed manager. The manager explained that they had prioritised staffing levels and training but improvements had been made since there appointment

Staff received regular training and knew how to meet people’s individual needs. Any important changes in people’s needs were communicated to all staff when they started their shifts, and there were regular daily meeting to discuss changes to people’s needs.

The staff were knowledgeable about the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff also understood the importance of giving people as much choice and freedom as possible. The manager had made appropriate applications for DoLS in order to keep people safe. Staff gained consent from people whenever they could and where people lacked capacity we saw that arrangements were in place for staff to act in their best interests.

People had appropriate food and drink and staff had access to accurate and up to date information to help them meet people’s dietary needs. However there was not enough staff to assist people who required support during meal times.

There were planned weekly activities and entertainment was arranged by the activities co-ordinator. However during our inspection we did not see many people being involved with activities.

Staff were kind and people appreciated the positive relationships they had with staff. This was also true for relatives. People’s privacy and dignity were respected and all confidential information about them was held securely. People using the service were complimentary about the staff providing the service. However we saw interaction from staff that was not supportive or caring.

Care plans were personalised and included information about people’s life history and interests. People’s individual needs were assessed and were specific to people as individuals. Staff were knowledgeable about how to manage people’s individual needs.

The service was well led by a manager who promoted a fair an open culture. They encouraged staff to take responsibility. The manager had a support structure in place from area managers. There was a quality management system in place which included a system of audits to identify where improvements could be made and to identify trends.