Elm Bank Care Home

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

Systems and processes were in place to monitor the quality of the care provided. However, the systems to monitor medicines administration, accident and incidents and staff recruitment had not always resulted in areas for improvement being identified and acted upon in a timely manner. The manager took immediate action to remedy this.

The manager was aware improvements were required in the service, they had met with the provider and had produced an action plan covering the areas where improvement was needed and progress was being made.

People were protected from the risk of abuse. People and family members told us they felt safe, and staff treated them well. We received positive feedback from people using the service that demonstrated staff treated them with kindness and compassion.

People were supported by staff that were safely recruited. There was sufficient staff deployed throughout the service to meet people's needs. People were supported by staff that received appropriate training and support to fulfil their roles and responsibilities.

People were supported to maintain a balanced diet. Staff worked with health care professionals as and when required to promote people's safety and well-being.

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.

Opportunities were available for people and family members to share their views. Feedback received from people using the service, relatives and staff was used to drive improvement at the service.

The manager and provider were receptive to the inspection and took immediate action in response to the inspection findings.

Rating at last inspection

The last rating for the service was Requires Improvement, published on 03 November 2020. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted through information shared by the local authority that improvements had been made at the service. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-Led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Elm Bank Care Home on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Safe arrangements were in place for visitors to the service including professionals and others. This included a visitors booking system, rapid LFD testing, hand washing and PPE stations.

Staff and visiting professionals were asked to provide evidence of their vaccination status against COVID-19 prior to entering the home.

A programme of testing for COVID-19 was in place for all staff and residents.

Stocks of PPE (personal protective equipment) were readily accessible to staff and visitors, and regular checks were made to ensure they were being used.

Isolation, cohorting and zoning plans were used to manage the spread of infection. This meant people self-isolated in their rooms when necessary.

Policies, procedures, risk assessments and guidance relating to COVID-19 were up to date, which supported staff to keep them and others safe. Systems were in place to ensure staff and visitors to the service were kept up to date with current COVID-19 guidance.

Management conducted regular checks and audits to ensure the service was kept clean and tidy.

Staff were trained in infection prevention and control procedures, including the procedure for safely putting on and taking off PPE (donning and doffing).

Elm Bank Retirement Village is a residential care home providing personal for up to 115 people aged 65 and over and for people living with dementia. At the time of inspection there were 86 people living at the service.

Elm Bank Retirement Village provides accommodation over three floors, divided into five separate areas. One area for people who are mostly independent and two areas for people who require residential care. Two other areas were for the care of people living with dementia.

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

The provider had not always followed government guidelines for the testing for Covid-19 of staff and people using the service due to the provider’s concerns about the reliability of the supply of testing kits, although this had been rectified after the inspection. Staff followed infection control procedures to protect people from the risk of infection.

The provider had not made provision for people who could not access the garden to speak with their relatives by any other means. However, people who were able to access the gardens were supported to meet with their relatives whilst maintaining social distancing. The manager was exploring ways of seeking people and their relative’s feedback.

The provider had not always ensured oversight of the regular assessment and monitoring of the health and safety of the home. The provider had not ensured staff had followed procedures for monitoring of the water systems or carried out actions from fire risk assessments in a timely way.

The provider had recently changed their deployment of staff and were recruiting staff to ensure existing and future staffing levels would meet people’s needs. Staff were recruited using safe recruitment practices.

People’s risks were assessed, and staff followed care plans that mitigated these known risks. There was good communication between staff to ensure they understood people’s changing needs.

The manager had developed good working relationships with the district nurse team; this had enabled staff to develop their practice.

People were protected from the risks of abuse or poor care as the provider had systems in place to identify, report and learn from safeguarding incidents.

People received their medicines safely as staff followed the provider's policies and procedures.

The provider and manager carried out regular audits and checks to ensure people continued to receive high quality care and continually looked for ways to learn from incidents and improve care.

The provider had appointed a new manager who had the skills, enthusiasm and compassion to promote a positive culture within the home. Staff told us they felt supported and valued.

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 24 October 2018). At this inspection we found areas that required improvement.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and management oversight. 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 have found evidence that the provider needs to make improvements. Please see the safe and well sections of the full report. We found no evidence during this inspection that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elm Bank Retirement Village on our website at www.cqc.org.uk.

Elm Bank Retirement Village is a residential care home that can provide personal care for up to 115 people, some of whom have dementia care needs. At the time of the inspection, 111 people were living at the service.

People’s experience of using this service:

Staff were not always provided with sufficient training. Many training courses that staff had undertaken had expired. There had not been sufficient oversight or actions taken to ensure staff kept up to date with training.

There was not a registered manager in place. The service had been without a registered manager for an extended amount of time.

People and their relatives told us they continued to receive safe care, and staff we spoke with understood safeguarding procedures and how to raise concerns. Risk assessments were in place to manage risks within people’s lives.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out.

Medicines were stored and administered safely within each person’s room.

Staffing support matched the level of assessed needs within the service during our inspection. People told us there were generally enough staff, and call bell logs we saw showed that people were responded to promptly.

Staff acknowledged there had been several changes in management, but told us they were supervised well and felt confident in their roles.

People had mixed feedback on the quality of the food, but told us they had a good choice and had snacks and drinks as they required. Food and fluid monitoring was carried out accurately for those who required it.

Healthcare needs were met, and people had access to health professionals as required. People's consent was gained before any care was provided, and they were supported to have maximum choice and control of their lives.

Staff treated people with kindness, dignity and respect and spent time getting to know them. People were supported in the least restrictive way possible. Care plans reflected people likes, dislikes and preferences.

An activities programme was in place and activities staff were deployed throughout the home on a daily basis.

People and their families were involved in their own care planning as much as was possible. A complaints system was in place and used effectively.

The management team were open and honest, and worked in partnership with outside agencies to improve people’s support when required.

Rating at last inspection: Good (Published 27 June 2017)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The overall rating has deteriorated to requires improvement.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to meet people’s needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on-going professional development that they required to carry out their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated people with respect, kindness and courtesy. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences. People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open culture. The registered manager was a positive role model in the home. People and relatives told us that they had confidence in the manager’s ability to provide consistently high quality managerial oversight and leadership to the home.

We found that people’s needs had been assessed and regularly reviewed. Care staff we spoke with were knowledgeable about people’s needs and supported them well.

We found that the provider had supported their staff in relation to their responsibilities which enabled them to give care in a safe and appropriate manner.

We saw that the provider undertook a range of quality audits to check and monitor the quality of the service provided.

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. Their name appears because they were still a Registered Manager on our register at the time.

We found that there was regular communication between Kettering General Hospital NHS Foundation Trust and Elm ward to make sure that the discharge plans for the residents were reviewed regularly and that people experienced minimal delays in finding their preferred permanent residence.

We found that people had been supported at Elm ward to achieve a good quality of life at their permanent place of residence.