Archived: Elaine House

' 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?

We were unable to speak to the majority of people who lived at the home because of the nature of their condition. Therefore we spoke with staff and observed their practices to determine how care and support was carried out. We spoke with staff from the local authority's contracts and commissioning team and safeguarding adults' team. The member of staff from the contracts and commissioning team, whom we consulted, expressed concerns about people's care and welfare and also the condition of the premises.

The provider's representative informed us that some of the required actions concerning the premises had not been carried out due to 'financial reasons' and the fact that the home was closing.

We concluded that people and others were not protected from the risks associated with unsuitable premises since the provider had still not taken steps to provide care in an environment that was adequately maintained.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No applications were in process.

Is the service effective?

We found that suitable arrangements were now in place to ensure that moving and handling equipment was properly maintained and safe to use.

We saw that extension leads were available for the call bell system which meant that people were able to use these to call for assistance. We checked the call bell system which was fully operational.

We observed that each person who had been assessed as needing a wheelchair had one. These were clean and foot rests were in place.

Is the service caring?

There were seven people receiving care on the day of our visit. We noticed that each person had a plan of care which aimed to promote their health and welfare.

We observed that care workers showed patience and gave encouragement when supporting people.

We saw that people looked clean and presentable. However, we found that staff had not documented when they had assisted people with a bath or provided assistance with their personal care since February 2014.

Is the service responsive?

We read people's care plans and noted that health and social care professionals had been contacted when concerns were raised. Following one person's weight loss, a referral had been made to the dietitian. However, we saw that two people had a history of falls and it was not clear how their care was planned and delivered to take account of this.

We observed that staff interacted kindly and patiently with people. However, there was limited evidence of meaningful activities which had been undertaken to occupy their attention.

Is the service well-led?

In this report the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of this inspection. Her name appears because she was still the registered manager on our register at the time. The previous registered manager had left in October 2013. A senior care worker was overseeing some managerial duties. The provider's representative worked most days at the home. However, by her own admission, she was not aware of certain checks and tests which needed to be completed, since she did not have a background in care.

As a result of the impending closure of the home, staff morale was low. However, staff said that the imminent closure did not impact on the care which people received.

We found that actions had not always been taken in response to the concerns we had raised at our previous inspection concerning people's care and welfare and the premises.

We found that people and others were not protected from the risks associated with unsuitable premises and there was not enough equipment to promote the comfort, dignity and safety of people.

There were not enough qualified, skilled and experienced staff to meet people's needs and staff had not received appropriate training for their professional development.

We considered that staff records and other records relevant to the management of the service were not always accurate or fit for purpose. Certain records could not be located promptly when needed.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Her name appears because she was still a Registered Manager on our register at the time.

We spoke with four relatives of people who lived at the home to find out their opinion of the service. A relative told us, 'It is a very homely place.' One person informed us, 'Good food, good people and good place. You can't fault it.'

We also contacted a number of health care professionals to find out their opinion of the service. These included a GP, psychiatrist and district nurse.

We concluded that if people did not have the capacity to consent, the provider acted in accordance with legal requirements.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People were supported to be able to eat and drink sufficient amounts to meet their needs.

We concluded that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

People were made aware of the complaints system. This was provided in a format that met their needs.

We found that there were enough qualified, skilled and experienced staff to meet people's needs.

We concluded that people were cared for by staff who were supported to deliver care safely and to an appropriate standard.

We found that the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

We concluded that people's personal records and those relevant to the management of the service were accurate and fit for purpose.

We found that people's privacy, dignity and independence were now promoted. Staff now transferred people using the hoist in a way which promoted their dignity. Trips into the local community were now carried out. One person said, 'There's always something going on.'

We found that care plans now reflected the needs of the people who lived there and gave staff detailed guidance on how to look after them. People were now assisted with diet and fluids throughout the day and assisted or prompted to use the toilet. One relative who had who expressed concerns during our last visit told us, 'They weren't getting onto things quick enough before, but now they are.'

We found that people were now cared for in a clean and hygienic environment. The two relatives with whom we spoke told us they had no concerns about the cleanliness of the home.