Elm Bank Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

We did not look at this key question at the last assessment.

At this assessment we have rated this key question as Good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People remained at the heart of their care and were actively involved in decisions about their support. One person told us,“I think I am well familiar with both my relatives’ care plans; we sort it with one of the seniors and I get updates if something changes.”Care plans were person-centred, regularly reviewed, and reflected individuals’ preferences and how they wished to be supported.

The service had begun implementing a “Cloud - All About Me” display at the entrance to people’s rooms to promote personalisation. However, we observed that some people’s preferred names were not displayed. This was raised with management, and while some corrections were made during the assessment, not all were addressed.

Interactions between all of the staff and people were mainly positive with staff engaging with people respectfully and addressing people by name, contributing to an inclusive and person-centred atmosphere. However, we observed one person being ignored when asking for help, resulting in visible distress. Another person was hoisted without any explanation or interaction, which did not reflect the otherwise person-centred approach observed. These inconsistencies suggest that while the service is committed to person-centred care, further work is needed to ensure that this approach is consistently embedded in everyday practice.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People were mainly supported to access healthcare services as required, and their information was kept up to date to ensure it could be shared promptly with hospitals and healthcare professionals in the event of a medical emergency. Staff demonstrated understanding of people’s health needs and worked on the same floor as much as possible, promoting continuity of care and familiarity.

Referrals and communication with health professionals were generally timely and effective, and care records showed evidence of strong partnership working. However, we found isolated instances of delay in contacting people’s GP, including for concerns around bowel movements and skin tears. These delays were not widespread but highlight the need for consistent escalation protocols.

A visiting professional commented, "It is usually the same staff per floor. It is generally okay, no concerns, but sometimes it’s hard to find staff.”This feedback reinforces the importance of maintaining consistent staffing levels to support continuity and responsiveness. However the management team told us 'Best practice is for the healthcare professional to wait in reception for a team member to greet them and provide any support they require during their visit to the home'.

The service had begun enhancing dementia care provision, supported by the provider’s dementia nurse, who was actively involved in staff training and development.

People were supported to stay in touch with family and friends using the telephone. We observed a member of staff facilitating a call by taking the phone to the person’s room, ensuring privacy and comfort during a call. Staff demonstrated a good understanding of individual communication preferences and delivered care in line with the Accessible Information Standard.

People’s communication needs were identified and supported, and the provider ensured that information was available in formats people could understand. We observed staff using plated meal presentations to help people make informed choices from the menu, supporting decision-making in a person-centred way.

People’s confidential information was mostly managed well. However, we observed a storeroom door containing people’s personal information left unlocked. This was brought to the attention of the management team, who assured us that the issue would be addressed promptly to maintain data security and confidentiality.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were actively involved in decisions about their care and support. They expressed confidence that concerns and complaints would be listened to and acted upon. One person shared, "One of my relatives had a problem with the bell, and that was sorted soon after it was reported."

People and their relatives were encouraged to give feedback through various channels, including ‘complaints and compliments, care review meetings, residents’ and family meetings and surveys. Records showed that concerns were documented, investigated, and analysed to identify trends and prevent recurrence. Staff told us that lessons learned were shared with them to improve practice, which we observed at the daily stand-up meeting. The main area of concern appeared to be related to food the management team had addressed this.

Residents’ meetings provided an opportunity for leaders to give updates and gather people’s views and concerns about the quality of care and service. Meeting minutes were available and included actions taken in response to feedback.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People’s needs were assessed prior to moving into the care home to ensure that any necessary adaptations or equipment were in place to support their care. Management told us that staff completed 3-hourly checks for the first 7 days to get to know the person and ensure a full and accurate assessment of their needs.

Referrals to specialist services, such as the falls team and speech and language therapy (SaLT), were made when there were changes in people’s needs, ensuring timely and appropriate interventions. Leaders and staff maintained positive working relationships with the local GP practice and other health and social care professionals, supporting a joined-up approach to care.

The care home was fully accessible, including the garden, allowing people who use wheelchairs to move around freely and maintain as much independence as possible. An accessible minibus was available, enabling people with mobility needs to participate in outings and community activities, further promoting inclusion and wellbeing.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Staff were trained in equality, diversity, and human rights, and people told us they felt treated equally and fairly. Care plans reflected what was important to individuals, including their family, social, cultural, and spiritual needs. Staff knew how to access key information to support people in medical emergencies, helping to promote good outcomes. However, we found that leaders and staff did not always recognise or respond to the barriers faced by people living with dementia and other health conditions. For example, mirrors had not been removed or covered with film, which can cause distress or confusion for people with dementia. All doors were the same colour, making it harder for people to navigate the environment independently.

We explored with the management team whether the use of coloured plates to support people with visual or cognitive impairments, had been considered; and they told us,“That is not the Barchester way,”although yellow plates were available if needed. Clinical oversight documentation for one person stated “no” to the need for a contrasting plate, while also noting that the person “just looks at the plate,” suggesting a potential unmet need. Additionally, there was no adaptable cutlery available on site. These findings suggested that whilst the service promotes inclusion in principle, there are missed opportunities to adapt the environment and provide resources to better support people living with dementia. This was discussed with the management team, who acknowledged the concerns.

Positively, we saw good evidence of personalised support that promoted inclusion and wellbeing. One person was supported to continue their employment and love of gardening, taking on the role of head gardener within the home. We also observed people actively participating in tasks such as drying dishes, believing they were working at the home, with staff respectfully engaging and telling them when it was time to “clock off.” These examples reflect a compassionate and enabling approach that honours people’s identities and preferences.

Overall, the service demonstrates a commitment to equitable care, but further work was needed to ensure that environmental adaptations and practical supports are consistently in place to meet the needs of those most at risk of poor outcomes.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s end of life wishes and preferences were clearly recorded and understood by staff. Where Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)decisions were in place, staff were aware of how to access this information and understood its significance.

Staff were trained in providing end of life care and demonstrated knowledge of where individuals’ end of life plans and associated documentation were stored. This ensured that care and support could be delivered in line with people’s wishes and legal requirements.