Archived: Elstree Court Care Home

Elstree Court Care Home accommodates up to 41 people in an extended and adapted building. It

provides accommodation and facilities over 3 floors and most areas have level access with chair lifts available in areas where steps are located. At the time of inspection there was 38 people living in the service. People’s needs were varied and included nursing needs, and support with dementia and memory loss.

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

People received individual time with staff to engage in activity and entertainment that met their individual needs. Activity staff were keen to promote well-being for people and ensured regular social interaction.

Complaints were recorded and responded to effectively. People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be. People's communication needs were assessed and responded to. End of life care was planned and involved additional health care professionals when needed.

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.

There was a stable management structure and staff felt well supported and valued. There was a positive culture and team spirit amongst the staff. Feedback from staff, relatives and visiting professionals was positive about the leadership of the service.

The registered manager was committed to maintaining and developing a quality service.

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 12 June 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service

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.

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.

The home was clean and well maintained. There was a regular cleaning programme and the housekeeping team were knowledgeable regarding current Covid-19 cleaning guidelines. They had received specific training on the cleaning measures required to prevent the spread of Covid-19.

The home was currently closed to all visitors due to a recent Covid-19 outbreak. However, visiting had continued for those people at the end of their life, with individual risk assessments to safeguard people and visitors. The registered manager with the provider was establishing safe systems and procedures for safe visiting in accordance with government guidelines. There was information on the home’s website on visiting and the registered manager was also in contact with family and friends about visiting arrangements. Staff had supported people to maintain contact with their loved ones with the use of video calls and telephones during the pandemic.

There were systems in place to ensure that people who had tested positive for Covid-19 were isolated in their own rooms all of which were single occupancy and most had en-suite facilities. People who were not isolating and chose to visit the dining or communal areas were supported by staff to maintain social distancing. For example, chairs and tables had been re-arranged to allow more space between people. Any activities arranged were limited to small groups.

A good supply of personal protective equipment (PPE) was available and staff had received specific Covid-19 training, this included guidance for staff on how to put on and take off PPE safely. Senior staff completed a twice daily review on staff competence and appropriate use of PPE. Staff were seen to be following correct IPC practices. Hand sanitisers and PPE were readily available throughout the home.

Regular testing for people and staff was taking place, in accordance with government guidelines. Staff had received training on how to complete some routine testing at home to support this programme. The providers were keen to support staff wellbeing through this difficult time and had provided a free support system through their insurance company, which they could access at any time for support.

We found the following examples of good practice.

The registered manager told us that staff had been wearing masks since the start of the pandemic, before it became government guidance. The registered manager felt that this was key in the prevention of COVID-19 in the home.

Staff had guidance to follow should they have an outbreak in the home. The registered manager understood how to zone the home to prevent the spread of infection into areas with people confirmed with COVID-19 and areas without. The registered manager had kept four bedrooms free from admissions in order to use this area of the home for any suspected or confirmed cases of COVID-19.

Risk assessments had been completed for all staff members to determine whether they would be at increased risk of COVID-19. The registered manger had planned that if there was an outbreak at the home, staff who were medium or high risk would only work in areas of the home that were COVID-19 free.

Elstree Court Care Home accommodates up to 41older people in an extended and adapted building. It provides accommodation and facilities over three floors and most areas have level access with chair lifts available in areas where steps are located. Care is provided to people whose main needs relate to nursing, and related physical health needs. This includes people who have had a stroke or live with a chronic health condition like Multiple Sclerosis, Diabetes or Motor Neurone Disease. People's nursing needs varied, some had complex nursing and care needs, others also required support with dementia and memory loss. Elstree Court Care Home also provides end of life care and used community specialist to support them in this care.

The service had a registered manager in place. 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.

At the time of this inspection 33 people were living in the service. Elstree Court Care Home was taken over by a new provider at the end of December 2017 and this is the first inspection under new ownership.

The provider had not ensured everyone had an opportunity to engage in meaningful activity. There was an activities co-ordinator who had developed an activities programme. This provided some group activity but did not ensure people’s individual needs were responded to effectively. We have made a recommendation that the provider seeks advice, guidance and training from a reputable source, to support staff in providing suitable activities and entertainment to meet people’s individual assessed needs.

People were happy with the care and support they received and they felt safe. Family members were complimentary about the care and support provided to people. Visiting professionals provided very positive feedback on the staff and the delivery of care. Medicines were handled safely and risks to people’s health and support were identified and responded to appropriately.

People were looked after by staff who knew and understood their individual needs well. Staff were kind and treated people with respect, and promoted their individuality. One relative complimented the staff and said, “It is wonderful here, I thought they had kindness lessons, they are so wonderful and kind.” Staff spoke to people in an appropriate way, promoted communication and took a genuine interest in what they had to say. There were enough staff to respond to people’s care needs on a daily basis.

Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse or discrimination. Recruitment records showed there were systems which ensured as far as possible staff were suitable and safe to work with people living in the service. Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had an understanding of DoLS and what may constitute a deprivation of liberty and followed correct procedures to protect people’s rights.

People were supported to receive regular drinks and the meals that reflected their choices and needs. Visitors told us they were welcomed and people were supported to maintain important relationships and friendships. The environment was clean and well maintained. The provider had ensured safety checks had been maintained and equipment and facilities in the service.

Feedback was regularly sought from people, relatives and staff. People were encouraged to share their views on a daily basis. People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be.