Elm Tree House

Elm Tree House is a residential care home providing personal care to up to 9 people. The service provides support to people living with mental health difficulties. At the time of our inspection there were 8 people using the service.

People’s experience of using this service and what we found

Risks to people were not always properly assessed to protect them from avoidable harm. Not all environmental risks for people using the service were safe, ensuring their safety, comfort and wellbeing. The registered manager was responsive to our feedback and took action to address the issues identified.

People's risk assessments were not always accurate and did not always provide staff with the information they required to safely meet people's needs. They were not always reviewed and updated following accidents and incidents.

Recruitment procedures were not always robust, and concerns were raised regarding staffing levels.

Peoples medicines were mostly administered safely by staff, although best practice guidance was not always being followed in relation to a clinical task delegated by a health professional.

The governance system had failed to identify the areas for improvement that we found during the inspection. The provider was responsive to address the shortfalls found within this inspection and took immediate action.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they felt safe and liked living at Elm Tree House. Staff supported people in a kind and compassionate way, considering their dignity and respecting people's rights. Throughout the inspection we observed kind, relaxed, compassionate and caring interactions between people and staff.

Infection control procedures and measures were in place to protect people from infection control risks.

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17 October 2017)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified breaches in relation to safe care and treatment and the management of the service at this inspection. We have also made recommendations in relation to medicines and staffing.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection in September 2015, the service was rated Good

At this inspection we found the service remained Good.

Why the service is rated good.

People felt safe at the home and with the staff who supported them. There was a robust recruitment process which minimised the risks of abuse to people. One person said, “No one here would harm you.” There were enough staff to safely assist people with their needs and support them to make use of community facilities.

People received their care and supported from staff who were well trained and skilled in recognising changes in people’s health and well-being. People were supported to manage their own health and staff assisted people to attend appointments. One person told us, “They help me at appointments because I don’t always understand things.” 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.

People were cared for by staff who understood their needs and were non-judgemental. People said they were able to talk to staff because they were patient and kind. One person told us, “I talk to staff when I’m worried. It helps a lot.” Staff respected people’s privacy and dignity and spoke with people in a respectful manner.

People received care and support which was personalised to their individual needs and choices. People were able to follow their own routines and make decisions about their care. Staff adapted the care they provided to meet people’s changing needs. People knew how to make a complaint and said they would be comfortable to do so. One person said, “Where I’ve had complaints they have been sorted out with no bad feelings on either side.”

People benefitted from a provider and registered manager who were approachable and listened to the views of people who lived at the home. There were informal and formal quality assurances systems which helped to make sure the home continually improved the care provided to people and maintained their safety.

Further information is in the detailed findings below