Elm House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

At our last inspection we found people were not always involved in choosing what they wanted to eat. There were no snacks available, and tea and coffee had been kept in the office. This was a breach of regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found this had been addressed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed a comprehensive assessment of each person’s physical and mental health either on admission or soon after. Care plans reflected a good understanding of people’s needs, including information around people’s communication support needs. Support plans set out current needs, promoted strategies to enhance independence and promote activities of daily living. Care plans were reviewed regularly and updated immediately when people’s care and support needs changed.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People received support to eat and drink enough to maintain a balanced diet. People were involved in choosing their food, shopping, and planning their meals. Menus reflected a variety of foods including people’s cultural needs. Staff supported people to be involved in preparing and cooking their own meals in their preferred ways. Fridges and freezers were well stocked, and snacks were available for people. Varieties of drinks were freely accessible in the kitchen and people were able to help themselves to what they wanted. During the inspection, we observed a person getting a snack and making themself a hot drink. A relative commented, “[Person] waits until he is offered drinks or snacks. But it is available.They usually have a drink and fruit on the kitchen table where people can help themselves.”

People’s care and support needs were reviewed in line with legislation. Care plans were regularly reviewed by staff and people were involved in these reviews. When there were reviews of their placement conducted by placing authorities, staff supported people to provide their opinions and experiences of their care.

The provider worked well across teams and services to support people. Staff understood each person’s individual care needs and helped them access services and attend appointments. These included specialist appointments as well as routine healthcare checkups. Staff from different disciplines worked together as a team to benefit people. They supported each other to make sure people had no gaps in their care.

The service worked closely with healthcare professionals such as occupational therapists, learning disability teams and psychologists to maintain and improve people’s wellbeing. The home also worked with the Care Homes Assessment Team (CHAT). CHAT supported the home with a multidisciplinary team of healthcare professionals.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had health actions plans/ health passports which were used by health and social care professionals to support them in the way they needed. These documents included information on how to communicate effectively with people in their preferred way. People were supported to attend annual health checks, screening and primary care services.

The service ensured that people were provided with joined-up support so they could travel, access health centres, education, social events and day centres. This improved people’s wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

People’s outcomes were monitored through regular reviews of care. People were involved in reviews as were, where appropriate, family members. Staff understood the importance of involving people and monitoring their care and support needs to ensure wellbeing. Relatives said, “I have seen his careplan,and I have input into it” and “Yes,I am involved in discussions about his care.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff empowered people to make their own decisions about their care and support. Staff knew about people’s capacity to make decisions through verbal or non-verbal means, and this was well documented. For peoplethat the serviceassessed as lacking mental capacity for certain decisions,staffclearly recordedmental capacity assessments and anybest interest decisions. Staff were able to tell us what consent meant and how this was integrated into the care provided. One staff member spoke to us about asking for consent and explaining the task before providing any personal care to people.