All inspections: The Elms Care Home - Care Quality Commission

The Elms Residential and Nursing Home provides accommodation, personal care and nursing care for up to 37 older people including those living with dementia. Accommodation is located over two floors. There were 28 people living in the home when we visited.

This inspection was unannounced and took place on 12 November 2015. During our previous inspection on 13 May 2014, we found that all of the regulations that we looked at were being met.

The home had a registered manager in post. 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 and associated Regulations about how the service is run.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Staff had received training and had an understanding to ensure that where people lacked the capacity to make decisions they were supported to make decisions that were in their best interests. People were only deprived of their liberty where this was lawful.

The provider had a robust recruitment process in place and staff were only employed within the home after all essential safety checks had been satisfactorily completed.

People’s privacy and dignity were respected at all times. Staff were seen to knock on the person’s bedroom door and wait for a response before entering and closing the door to protect people’s dignity when providing personal care.

People’s health, care and nutritional needs were effectively met. People were provided with a varied, balanced diet and staff were aware of people’s dietary needs. Staff referred people appropriately to healthcare professionals. They accepted and followed advice and guidance from other professionals. People received their prescribed medicines appropriately and medicines were stored in a safe way.

Care records we looked at and people who we spoke with showed us that wherever possible people were offered a variety of chosen social activities and interests.

The provider had an effective complaints process in place which was accessible to people, relatives and others who used or visited the service.

The provider had effective quality assurance systems in place to identify areas for improvement and appropriate action to address any identified concerns. Audits, completed by the provider and registered manager, showed the subsequent actions taken, which helped drive improvements in the home.

During this inspection we spoke with 12 people who lived at the service, staff, the manager who was supporting the service during the recent registered manager vacancy and the Area Director.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions. Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found.

Is the service safe?

Potential risks had been identified and recorded clearly in people’s care records. We saw that these risks had been reviewed on a regular basis to ensure that people were kept safe.

Equipment at the home had been regularly serviced and regular fire safety checks had been undertaken to ensure its safety for people.

Is the service effective?

People we spoke with were very happy with the care they received. The care records provided detailed information to ensure people received care and support in a consistent way.

Is the service caring?

People we spoke with told us that the staff were very helpful and allowed them to be as independent as possible. Staff we spoke with were knowledgeable about the care and support needs of the people they cared for. We heard and saw staff treating people with patience and respect throughout our inspection.

People’s preferences, interests and diverse needs including their likes and dislikes, had been recorded and people’s needs had been provided by staff in accordance with their wishes.

Is the service responsive?

We found that calls bells were responded to by staff in a timely manner meaning that people did not have a long wait to be assisted. People’s concerns and complaints were responded to in a professional and open way.

Is the service well led?

The home had quality assurance systems in place and regular audits had been carried out. Records we saw showed that any shortfalls were addressed promptly.

People told us that staff members obtained their consent before supporting them with care or treatment. Care records did not record which decisions people were able to make for themselves and which decisions they did not have the capacity to make.

People received the care and support they required to improve their health and well-being. Care records were written in detail and provided clear guidance to staff members. Appropriate assessments were completed to identify risks or people’s care needs and the actions required to reduce the risk or meet the care need.

The home and grounds were appropriately maintained. Equipment was properly checked and serviced on a regular basis.

Staff members received supervision and training from the provider or from external sources to ensure they had the skills and support to properly carry out their roles and care for people.

The service had a policy and procedure to guide people in how to make a complaint. People told us they would be able to make a complaint if they needed to.

We did not speak with people during this inspection because we conducted the visit to follow up specific areas of concern in regard to the records kept about people.

Records relating to medicines were kept appropriately. Prescriptions and records for controlled drugs were properly completed, routine medicines had all been given when we visited and there were no missed entries in people's medication administration records.

The required pre-employment information and checks had been obtained before new staff members started working at the home.

Records that were required to be kept to detail the care and treatment provided to people were kept appropriately. These recorded actions staff members had taken, or had not taken, in providing care and treatment to people.

We observed that taff members were gentle, polite and spoke with people in a warm manner. People said they were able to make choices during the day, for example when to get up and go to bed, what they had to eat and when they ate. They confirmed that staff members were polite and that they were treated with respect.

People said their meals were nice, they were able to choose from a menu and that there were alternatives available. They confirmed that they were offered as much assistance as they needed in order to be able to eat.

We did not speak with people generally during this review as we were checking compliance with warning notices served in February 2012. We did, however, attempt to speak with specific people, although this was not possible. For those people who were not able to communicate easily with us we observed how staff interacted with them and found this was in a positive and supportive way. Staff members were polite, friendly and caring towards people living at the home.

We spoke with some of people living in the home during the course of the visit. We spoke with one person about the help they received from staff to increase their mobility. They told us that some staff members help them with exercises they were required to do but that not all staff did this. They said they would like all staff to help them with the exercises to strengthen their legs.

Another person who ate their meal in their room told us they usually received their meals on time. They confirmed that they get enough to drink and that staff members encouraged them to drink more.

People we spoke with and met had positive experiences of care and support provided at the home; they were engaged in tasks with staff members and participated in conversation. The atmosphere was congenial and staff members were polite and spoke in a warm and engaging manner. One person we spoke with said they were able to do what they want, when they want to. They said staff members were, "Very nice, very caring" and that they were always polite.

People told us that they felt they were cared for properly because staff members helped them with everything they needed help with. They received their medication in the way that was best for them.

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: The Elms Care Home

All Inspections

12 November 2015

During a routine inspection

13 May 2014

During a routine inspection

16 October 2013

During a routine inspection

28 September 2012

During an inspection looking at part of the service

3 May 2012

During a routine inspection

6 March 2012

During an inspection looking at part of the service

17 January 2012

During an inspection in response to concerns

5 September 2011

During a routine inspection

Reports under our old system of regulation