Background to this inspection
Updated
22 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector and an assistant inspector.
Service and service type
Elm Farm Residential Home a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager who had registered with the Care Quality Commission. They were also the provider and that means they are legally responsible for how the service is run and for the quality and safety of the care provided. We refer to them as the provider within this report.
Notice of inspection
The inspection took place on 30 October 2019 and was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications the provider is required by law to send us about events that happen within the service such as serious injuries. We sought feedback from the local authority who work with the service. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with five people who lived at the home and one person’s relative about their experiences of the care provided. We spoke with the deputy manager, one volunteer, one senior care worker, three care workers and the cook. We also spoke with one visiting health professional.
We observed the care people received. We reviewed four people's care records and four people's medicine records. We looked at a sample of records relating to the management of the service including quality audits and people's feedback. We also reviewed three staff files to check staff had been recruited safely.
After the inspection
We contacted the provider and the deputy manager to seek confirmation of the actions taken to drive forward improvement and make the necessary registration changes.
Updated
22 January 2020
About the service
Elm Farm Residential Home is a residential care home providing personal care for up to 12 older adults. There were 11 people living in the home at the time of our inspection visit.
People's experience of using this service and what we found
Environmental risks were not always identified and mitigated which placed people at risk of harm. The provider’s quality assurance systems required improvement to ensure the checks undertaken were always effective to keep people safe. Action was taken to improve risk management following our inspection visit.
We had not been informed, as required, when important changes to the provider partnership had occurred in 2017. Following our visit, the provider was taking action prompted by CQC to address this which has caused the publication of this report to be delayed.
The management of people’s medicines was not consistently safe. Prompt action was taken to address the issues we identified. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Action was taken to address this by the deputy manager.
Staff were recruited safely, and staff were available to meet people’s needs in a timely way. People felt safe and had confidence in the ability of the staff team to deliver their care effectively.
Staff enjoyed their jobs and spoke fondly about the people they cared for. Most people’s care records were written in a personalised way and provided staff with the information they needed about people's likes, dislikes and preferences. Staff understood how people preferred to communicate and the information provided to people was being reviewed by the deputy manager to ensure people could understand it.
People's right to privacy was respected and people received dignified care from staff who understood the importance of promoting their independence.
People enjoyed the range of social activities provided to occupy their time. People had enough to eat and drink and had access to health professionals when needed. People were supported to practice their religion and people's end of life wishes were documented if they had chosen to share this information.
People had opportunities to feedback their views on the service they received. Recent feedback showed people knew how to complain and they were happy with how their home was run. The environment was clean and infection prevention and control measures were effective.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Following our inspection, we notified the local authority commissioners about the areas of concern we
identified.
We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated
Activities) Regulations 2014. These were:
Regulation 12 Regulated Activities Regulations 2014 - Safe care and treatment
Regulation 17 Regulated Activities Regulations 2014 - Good governance
Rating at last inspection
The last rating for this service was Good (published 22 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.