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Archived: Elswick Hall Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 19 July 2018

The inspection took place on 4, 5 and 8 June 2018 and was unannounced on the first day, which meant the provider did not know we were visiting. This was the first inspection since the service registered with the new provider in May 2017.

Elswick Hall Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single packages under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Elswick Hall Care Home is registered to provide accommodation for up to 47 people with residential and nursing care needs. Some of the people who lived at the service had complex needs, including those who were living with dementia and people with severe brain injuries. At the time of the inspection, there were 23 people living at the service. The service only had 45 bedrooms and the provider was in the process of arranging to update their registration.

The service did not have a registered manager. A new manager had recently commenced employment at the service in April 2018. 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.

A new management team were in place and were working hard to address the issues we had found during our inspection, some of which the provider was already aware of.

Medicines were not managed appropriately at the service. For example, thickeners were stored insecurely in dining areas. Thickeners are used to support people who have swallowing difficulties. However, they can pose a danger to people if consumed inappropriately. Some medicines lacked detail on how staff should administer them and medicine records were not always fully completed.

People had not always had pre-assessments completed before they moved into the service. Risk assessments, care plans and other associated documentation needed to fully support staff to meet people’s needs were either not in place or not fully completed. The new management team were in the process of rewriting every person’s care records, including those in connection with people’s capacity. Due to the nature of the service, we would expect to have seen a number of accidents and incidents involving the people living at the service. However, not all records were available and we were only able to see one recent accident. This meant that we could not be sure accidents and incidents were recorded and dealt with appropriately.

The provider supported people with their finances, although no care plans or risk assessments were in place and we found considerable amounts of money for two people held within the company’s bank accounts rather than in the bank accounts of the individuals concerned.

Checks on people’s pressure relieving mattresses did not happen regularly and we found people’s mattresses were not always set correctly. This meant people were put at further risk of pressure damage.

We found some issues with infection control, including kitchen staff not having suitable changing facilities. The provider had been in touch with the infection control lead for care homes to support them in any improvements needed and intended to address issues highlighted, including via refurbishment work planned.

Fire drills had not been completed as often as they should have been, although the provider rectified this during our inspection. Some actions on the fire risk assessment were outstanding and the provider was in the process of addressing these.

On arrival at the inspection, we found only one member of staff on duty on the upper levels of the service for the people living there. Some people required two staff to support them. The provider recognised at the

Inspection areas

Safe

Inadequate

Updated 19 July 2018

The service was not safe.

Medicines were not managed safely. Risk assessments were not always up to date and records of incidents were not all available as they should have been.

People's finances needed to be reviewed to ensure they followed best practice.

Infection control procedures needed to be followed fully.

Staff were aware of their safeguarding responsibilities and knew what to do if they had any concerns.

Effective

Requires improvement

Updated 19 July 2018

The service was not always effective.

People were not always assessed before moving into the service to ensure their needs could be met.

Staff were trained and supported and the provider was working to address any gaps in these processes.

The manager understood their role in connection with the Mental Capacity Act 2005 and of the Deprivation of Liberty Safeguards and they worked within legal guidelines. Best interest decisions and recording in connection with people's capacity were not always recorded.

People were supported to eat a range of different foods, depending on their needs. However, staff had not always tried methods to allow people to choose meals themselves.

Caring

Requires improvement

Updated 19 July 2018

The service was not always caring.

Staff we spoke with showed caring attitudes. However, this was not the case for all staff and a number of staff had been suspended or dismissed due to their lack of care.

People were seen to be treated with dignity and their privacy maintained. Independence was promoted.

Responsive

Requires improvement

Updated 19 July 2018

The service was not always responsive.

People had not always received care which was person centred. Care records were not always in place or completed fully.

Activities were provided and enjoyed by some people but review was needed for some people to ensure they received suitable stimulation.

The provider’s complaints procedure was displayed around the service and people and their relatives were aware of how to complain if they needed to.

Well-led

Requires improvement

Updated 19 July 2018

The service was not well led.

A registered manager was not in place. A new manager and senior management team had recently been appointed and staff and families thought they were now working well to improve the service.

The provider had an overall quality assurance system, but it had not always been followed. The provider had taken over the service in May 2017 and had not yet fully addressed record keeping issues.

Meetings and/or surveys had been held for people and their families to allow them a way to feedback about the running of the service.