We carried out a review of the data available to us about Elvy Court Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Elvy Court Care Home, you can give feedback on this service.
Elvy Court Care Home is registered to provide people with nursing and residential care. It can accommodate older people, younger adults and people who live with dementia. It can also support people with physical and/or sensory adaptive needs.
At the time of this inspection there were 47 people living in the service. The service can accommodate up to 55 people. The service was provided over two floors with lift access. Each floor had its own lounge and dining room and all bedrooms had an en-suite toilet. There was also a café on the ground floor and a well-tended garden surrounded the home.
People’s experience of using this service
People and their relatives said were satisfied with the level and quality of care they received at Elvy Court Care Home. Although they said there were some niggles from time to time, they would recommend the service to others. One relative told us about their family member, “It is the best place for her. She is cared for in a non- judgemental way. She can do what she likes, accepted as she is, celebrated rather than judged.”
People continued to be protected from the potential risk of abuse. Individual risks were identified and steps taken to reduce them. Staff had the guidance they needed to minimise harm to people whilst supporting independence.
Staffing levels continued to be monitored so there were enough staff to meet people's needs. Recruitment practices were safe to ensure people were protected from the risk of unsuitable staff.
People continued to receive their medicines as prescribed by their GP. Medicines had been stored, administered, audited and reviewed regularly. One health care professional told us, “I have engaged with the home managers/seniors, who have been very responsive, collaborative and show their care and compassion to ensure their residents receive a high standard of care.”
We were assured that the service could respond to COVID-19 and other infection outbreaks effectively.
Everyone said the service was well-led and that the registered and deputy managers were approachable. There were systems to monitor the quality of the service being provided to people and gain their feedback.
The culture of the service was open and honest. Lessons had been learned when things had not gone the way that they should have gone. When people and relatives had raised issues during the inspection, they were immediately investigated, resolved to people’s satisfaction and apologies made when needed.
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 7 October 2020).
Why we inspected
The inspection was prompted in part due to concerns received about the assessment of risks and the overall management of the service. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns. The overall rating for the service remains Good. This is based on the findings at this inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elvy Court Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Elvy Court Nursing Home is registered to provide people with nursing and residential care. It can accommodate older people, younger adults and people who live with dementia. It can also support people with physical and/or sensory adaptive needs.
At the time of this inspection there were 46 people living in the service. The service can accommodate up to 55 people.
People’s experience of using this service and what we found
People told us they were safe at the service and well supported by staff. A person said, "The staff are good to me and I like them." In a thank-you card to the service a relative said, “Thank you for all the love and care you showed my mum. You made her final years a much calmer and happier time.”
People were safeguarded from the risk of abuse. Risks to health and safety had been managed and people received safe care and treatment. Medicines were managed safely in line with national guidance Sufficient staff were deployed and safe recruitment practices were in place. Infection was prevented and controlled. Lessons were learned when things went wrong.
People received care promoting their dignity and independence.
Quality checks monitored and evaluated the service, regulatory requirements were met and good team-working was promoted.
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 Requires Improvement (published 10 September 2019). The service was in breach of three regulations of the Health and Social Care Act 2008. These related to safe care and treatment, promoting people’s dignity and independence and quality check to monitor and evaluate the service.
The registered provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the registered provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to gain an updated view of the care and support people received. This was a planned inspection based on the previous rating. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led.
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 infectious outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has now improved to Good. This is based on the findings at this inspection. Please see the Safe, Caring and Well-led sections of the full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elvy Court Nursing Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Elvy Court Care Home is a residential care home with nursing for 55 older people and younger adults who have physical adaptive needs or who live with dementia. It can also accommodate people who have sensory adaptive needs.
At the time of this inspection there were 49 people living in the service of whom 34 lived with dementia. Some people had special communication needs.
For more details, please read the full report which is on the CQC website at www.cqc.org.uk
People's experience of using the service and what we found:
This inspection was prompted by video evidence received by the local safeguarding of adults authority. The authority concluded the evidence showed that a person living in the service had experienced physical abuse due to rough treatment and emotional abuse. The authority also found the evidence showed that the same person had not consistently received safe care and treatment. This was because they had not been correctly assisted to change position when in bed. This had increased the risk of them developing sore skin. Also, they had not been safely supported to drink to reduce the risk of them choking. These shortfalls had contributed to the person not receiving a caring and person-centred service. Given these issues there were also concerns about how well the registered persons were monitoring and evaluating the running of the service.
The local safeguarding of adults authority asked the registered persons for immediate assurances that suitable steps had been taken to protect the person from the risk of further abuse and unsafe care. A decision was made for us to inspect the service to ensure that people were kept safe and that risks to their health and safety were reduced. As a result we undertook a focused inspection to review the key questions ‘safe’, ‘caring’ and ‘well-led’ only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. Therefore, we did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
People and their relatives were positive about the service. A person said, “I’m good here and the staff are lovely to me.” Another person said, “No complaints from me as I have everything I need.” A relative said, "I chose this place because it has a homely atmosphere. And that’s what it is – a home from home where the residents come first.”
However, we found that the registered persons need to make further improvements. We noted that after the registered persons received the video evidence they had quickly taken action designed to keep people living in the service safe. This was so that all the people living in the service were safeguarded from the risks of abuse and unsafe care and treatment. Nevertheless, in practice some of the steps taken had not been well organised and did not provide a comprehensive response. Although this oversight had not resulted in people experiencing direct harm or unsafe care it had increased the risk of this occurring. It had also increased the risk of people not experiencing a caring and person-centred service that promoted their dignity.
During the inspection visit we raised these concerns with the registered persons. They assured us that steps would immediately be taken to address each of them. Soon after the inspection visit the registered persons sent us information confirming that our concerns had been addressed. They said that suitable quality checks had been put in place designed to ensure people were robustly protected from the risk of abuse and unsafe care and treatment. This was so they received a caring service that promoted their dignity. However, we need to be to assured that these quality checks will be sustained and will result in people consistently receiving safe care.
Our other findings were as follows:
Regulatory requirements had not been met.
Nurses and care staff had the knowledge and skills they needed. They assisted people to manage healthcare conditions in the right way.
People were supported to use medicines safely.
There were enough nurses and care staff on duty and safe recruitment practices were followed.
Lessons had been learned when things had gone wrong such as accidents, falls and near misses.
Good standards of hygiene had been maintained to prevent and control the risk of infection.
When people received care their right to privacy was respected and they were supported to make decisions about things that were important to them.
Confidential information was kept private.
People had been consulted about the development of the service.
Joint working was promoted.
Enforcement:
We have identified breaches of regulations in relation to safeguarding people from the risk of abuse and protecting people from unsafe care and treatment. There was also a breach of regulations in relation to the systems and processes used to monitor and evaluate the running of the service.
Please see the actions we have told the registered persons to take at the end of this report.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any further concerning information is received we may inspect sooner.
Elvy Court Care Home is a care service that provides personal or nursing care to up to 55 adults. There were 46 people living at the service at the time of the inspection. There are two floors in the service providing nursing care to older people with varying needs. People with complex general nursing needs were cared for on the ground floor and people living with dementia were cared for on the first floor.
People’s experience of using this service and what we found
People told us they received a good service and felt safe. The registered manager understood their responsibilities about safeguarding people from abuse. Staff had been appropriately trained and knew how to raise safeguarding concerns. Peoples medicines were managed safely. People said they received their medicines when they needed them.
Staff knew how to keep people safe from risks. Potential risks were recorded to make sure staff had clear written guidance on what to do to keep risks to a minimum.
When there were any incidents and accidents these were recorded, and steps were taken to prevent any re-occurrence. Staff understood how to prevent infection and wore protective equipment when necessary.
There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure and carried out relevant safety checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.
People's needs were assessed before they started using the service. People were supported to express their views and make decisions about their care. People had care plans that provided guidance for staff to provide care that was responsive to people's needs. Care plans were specific and personalised.
People were encouraged and supported to enjoy and participate in activities and hobbies if they wanted to. People and their relatives spoke highly of the activities provided. There was a lively, cheerful and inclusive atmosphere at the service.
People said they enjoyed the food and could access snacks and drinks when they wanted to. Staff supported people to maintain a balanced diet and monitor their nutritional health.
When people were unwell or needed extra support, they were referred to health care professionals and other external agencies. People’s end of life wishes were recorded and people were supported at the end of their lives to be comfortable and pain free.
Staff treated people with dignity and respect. Staff helped to maintain people's independence by encouraging them to care for themselves where possible. People were supported to do things they wanted to do. 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 knew how to complain, and any complaints had been resolved to people’s satisfaction. People were asked their opinions on the service by attending meetings and completing surveys, suggestions had been acted upon.
People and their relatives gave positive feedback about the service they received. They said the registered manager sorted out any issues they had.
Staff knew their roles and were able to tell us about the values and the vision of the service. There were adequate quality assurance measures in place. The service was well linked locally.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
Good – published on 25 October 2016.
Why we inspected
This was a planned inspection based on the previous rating. The service remained 'Good' overall.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Elvy Court nursing home was registered to provide nursing and personal care services for up to 55 people. There were 53 people living at the home on the day of our inspection.
Elvy Court nursing home was a purpose built home with nice gardens and a parking area at the front. There were two floors in the home providing nursing care to older people with varying needs. People with complex general nursing needs were cared for on the ground floor and people living with dementia were cared for on the first floor. All rooms had en suite toilet and vanity basin facilities. The entrance and reception area was light and airy with a ‘bistro’ offering a hot drinks machine and tables and chairs with easy access for people and visitors. There were various seating areas around the home, with some areas designed to be ‘quiet’ lounges. A spacious lounge on the ground floor led out onto a large, very pleasant private garden where people could sit when the weather was fine.
We last inspected the service on 15 June 2015. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to Regulation 10, Dignity and respect; Regulation 11, Need for consent; Regulation 12, Safe care and treatment; Regulation 17, Good governance and Regulation 18, Staffing. Following the inspection the provider sent us an action plan to show how they intended to improve the service and meet the requirements of the regulations.
At this inspection we found that the provider had taken action to address the breaches from the previous inspection and had made many improvements to the environment and the service provided. However there continued to be areas for concern around the safe management of people’s medicines. We made a recommendation about this.
There was a registered manager based at the service who had taken her post after the last inspection. 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 and their relatives told us they felt safe living at the home. They told us who they would speak to if they were worried about anything and were confident they would be listened to. We spoke to staff who were able to tell us how they kept people safe. They understood their responsibilities in ensuring people were safe from abuse and their role in reporting any concerns they had.
There were suitable numbers of staff to be able to provide the nursing and personal care people had been assessed as needing. Registered nurses were employed to provide the professional expertise required to respond to people’s often complex care needs. Care staff were not expected to undertake cleaning or cooking duties as experienced chefs and domestic staff were employed. This meant care staff concentrated on providing the care people required. Safe recruitment processes were used when employing new staff to make sure only suitable staff were employed to work with people.
The registered manager had a training plan in place and all staff received the training they required to carry out their role well. The registered nurses were supported by the provider to undertake training to ensure their professional development continued in order to keep their registration up to date.
People’s nursing and care needs were assessed before moving into the home by the registered manager and nurses to make sure they were able to cater for their individual needs. Following assessment, the nurses developed a care plan to record how to provide person centred care, taking into account people’s individual preferences and choices. We found that some care plans, particularly for those people who had a high level of nursing and personal care needs, did not provide the level of detail required to be confident all staff knew how to support people well. We noted that the registered manager had already identified this and had taken action to address the concerns.
Registered nurses assessed people’s needs and identified risks, putting measures in place to manage these. Some individual risk assessments provided only basic information. Risk assessments needed to be more robust to provide safe, person centred care, essentially for people with very complex nursing care needs. We made a recommendation about this
One activities coordinator was newly in post and another had recently been appointed and was due to start their new role within two weeks. There were activities for people to take part in if they chose. These were planned ahead and people were given information so they were able to decide if they wanted to join in. Those who were ill and being nursed in bed were visited by the activities coordinator and the staff to help prevent social isolation. More opportunities would be on offer when the newly appointed activities coordinator joined the home.
Complaints were investigated and responded to well as were accidents and incidents. The registered manager and the provider took the opportunity to learn from complaints received and incidents that had happened to be able to improve the service provided.
The property was maintained to a good standard. The provider had embarked on a whole refurbishment project which was still ongoing and due for completion in December 2016. The environment had been vastly improved which was appreciated by people, their relatives and the staff.
Surveys were carried out each year to gain the views of people, their relatives and staff. The provider carried out an analysis of the results in order to provide feedback and to make improvements where necessary.
The provider had a range of auditing processes in place to be able to monitor the quality and safety of the home. People, their relatives and the staff thought the home was well run and the registered manager was approachable and supportive. People and staff said the registered manager was present around the home many times a day and knew people and staff well.
This inspection was carried out on 15 June 2015. The inspection was unannounced.
Elvy Court is registered to provide Accommodation and nursing care for up to 55 older people, including people living with dementia. Accommodation was provided on two floors, with a passenger lift providing easy access between floors. People had a variety of complex needs including dementia, mental and physical health needs.
The service had a registered manager. 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 2014 and associated Regulations about how the service is run.
Avery Homes (Nelson) Limited took over the provision of regulated activities at Elvy Court Nursing Home in November 2014. This was our first inspection of the service under the new provider.
Avery Homes (Nelson)
Before our inspection we received information of concern from the local authority safeguarding team, a member of the public and a whistle blower. During our inspection most people made complimentary comments about the service they received. People told us they felt safe and well looked after. However, our own observations and the records we looked at did not always match the positive descriptions people had given us. There were mixed views from relatives about the service.
Systems to assess, monitor and improve the quality and safety of the service or identify and manage all the risks to people’s safety were not effective. Where shortfalls were identified during audits by the manager, action was not taken in a timely manner to improve the quality of the service. Staff understood how to safeguarded people from abuse.
People did not always receive their medicines as prescribed. Medicines were not always stored securely to ensure people’s safety.
People’s privacy and dignity was not respected because bedroom doors were left open throughout the home when people were in bed or in their rooms. There was no evidence that people were consulted about this practice.
People and their relatives felt there were not enough staff deployed in the service. People were left unsupervised for periods of time in communal areas. The provider did not have a clear system to assess how many staff were required to meet people’s needs and to arrange for enough staff to be on duty at all times.
People and their relatives were involved in planning their care. Care plans were personalised to make sure staff knew how to care for people’s physical, emotional and social needs. People were provided with opportunities to take part in a range of activities. Care plans were reviewed and updated regularly to make sure staff had up to date guidance about how to care for each person.
Staff felt well supported by the management team. New staff received induction training. All staff had essential training and opportunities for additional training. Each member of staff had an annual appraisal to assess their performance and any further training needs. Staff told us they received regular supervision.
People were complimentary about the food and were provided with enough to eat and drink. Choices of menu were offered each day. Some improvement was needed at mealtimes to make sure people were offered choices in ways they could understand and had as much control as possible over the content of their meals and portion sizes. We have made a recommendation about this.
There was a system for managing complaints about the service. People felt they were listened to and knew who to talk to if they were unhappy about any aspect of the service.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Guidance in the Mental Capacity Act 2005 was not always followed to make sure people were safe when they made decisions that were not in their best interest.
Staff were kind and caring in their approach and had a good rapport with people. The atmosphere in the home was calm and relaxed and there were lots of smiles and laughter.
People were supported to maintain their relationships with people who mattered to them. Visitors were welcomed at the service at any reasonable time and were complimentary about the care their relatives received. People were consulted through residents and relative’s meetings and their views taken into account in the way the service was run.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.