The inspection took place on 30 July 2018 and was unannounced. The inspection continued on 31 July 2018 and was announced. Elsadene is 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. At the time of the previous inspection in February 2016 Elsadene was registered as a hospital. On 4 January 2018 Elsadene changed its registration to a care home. For that reason, Elsadene was inspected as a care home under the Adult Social Care assessment framework.
Elsadene is a large, detached property in Weymouth. The home is set out over three floors and provides long term accommodation and care for up to 13 adults living with enduring and complex mental health needs. At the time of our inspection 11 people were living at the home.
The service had 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 felt safe. They were supported by staff with a good understanding of how to safeguard them and how to raise concerns either internally or externally if they suspected harm or abuse. People’s individual risks were assessed and reviewed. People were encouraged to take positive risks with restrictions minimised as far as possible.
There were enough staff to meet people’s needs and respond flexibly to unforeseen changes. People received their medicines on time and as prescribed. The home was clean and free from malodours. Staff understood their responsibilities to prevent and control the risk of infection.
The home carried out regular accident, incident and near miss audits. This included a description of what had happened, the result of the investigation, and follow up action taken. Learning was shared with people and staff. This helped reduce the risk of things happening again.
People had their needs comprehensively assessed to support their move to the home. This included their care needs and how they preferred to live their lives. People were supported by staff who had received an induction and shadow shifts with more experienced staff. People were supported to eat a balanced and healthy diet. They were given choice of what to eat and drink and could eat as much or as little as they wanted. People spoke highly about the food.
People were supported to attend appointments to maintain their health and well-being. Where people’s health needs changed there was timely contact with relevant health and social care professionals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people lacked capacity to make particular decisions they were supported by staff who were trained and worked in line with the principles of the Mental Capacity Act 2005.
Staff consistently demonstrated a kind and caring approach towards people. Interactions were warm, natural and positive. When people were feeling upset or worried staff supported them emotionally.
People’s privacy and dignity was supported at all times. They were given time and space to spend time alone relaxing or with friends and relatives. People were encouraged to maintain their independence.
People had thorough pre-assessments which had supported their move to the home. These included people’s needs, preferences, network of support, and their abilities. There was a wide range of activities available at the home. These supported and motivated people to maintain their interests and develop new skills.
People were supported to maintain contact with family and friends whether via visits, phone or social media. Relatives told us that they felt involved and included. They spoke positively of the difference the staff had made to their family members’ lives.
The home managed complaints in line with their policy. People expressed confidence that when issues were raised they were resolved in a timely way and to their satisfaction.
There was a positive and open culture at the home where everybody’s views were listened to and considered important. Staff understood and supported the vision of creating a low-key, low-stress environment where people could recover from episodes of feeling mentally and/or physically unwell.
Staff told us they enjoyed working at the home and felt supported by the management. Staff said they felt valued and motivated from having their efforts recognised and opportunities provided for personal development.
Regular team meetings were held to share information and learning. Annual away days were also held as opportunities to learn more about complex issues with input from invited speakers from health and social care. Feedback was sought from people living at the home with their thoughts then used to develop a plan of action.
The home had established and maintained good working relationships with health and social care professionals and a local college and university. This had resulted in pro-active in-reach services that helped to keep people mentally and physically well for longer and prevent unnecessary transfers to inpatient facilities. Student nurses were positive about their experiences on placement at the home.