Elworth Grange

Elworth Grange is a residential care home supporting up to 66 people with a variety of needs, including dementia. Accommodation is purpose built and is provided across three floors, consisting of individual bedrooms with en-suite facilities and access to a range of communal areas. At the time of our inspection there were 50 people using the service.

Peoples experience of using the service had what we found

People were happy with the care they received. One person’s account of their experiences raised an issue wheret they felt some staff did not always take their specific communication needs and style into account. This combined with training for staff in effective communication is raised as a recommendation in this report.

People felt safe and happy with the approach of the staff team. The service had sent key information to the local authority relating to care concerns each month. A safeguarding referral had been made following information received and this is currently under consideration by safeguarding teams.

Risk assessments were in place relating to the hazards faced by people in their daily lives and had been taken into account. These assessments extended to checks of equipment safety and other equipment used by people.

Staffing levels met the needs of people with observations made of staff responding to people promptly. People we spoke with confirmed there were enough staff. The staffing compliment had relied on agency staff, but new staff had been recruited appropriately.

The environment remained clean and hygienic throughout.

The manager of the service had been appointed prior to the inspection. While information on the deregistration of the previous manager had been received, the provider had not informed us of management arrangements. This was done retrospectively.

Robust quality assurance systems were in place and people living at Elworth, their relatives and staff had the chance to express their views.

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. While arrangements for ensuring people had deprivation of liberty safeguards in place to protect them; one person’s DoLS had expired and had lapsed for a short time. We have raised this as a recommendation in this report for the provider to improve oversight of DoLS applications.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 January 2022) a breach in governance of the service was identified. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection. You can read the report from our last inspection, by selecting the ‘all reports’ link for Elworth Grange 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.

Peoples experience of using the service had what we found

The provider's quality systems were not sufficiently robust to identify the concerns we identified during this inspection. Medicines were not always managed safely. This was because some information about medicines administration was incorrect or absent. Improvements were also needed in other records including staff recruitment records and fire safety records.

We have made recommendations about best practice guidance on medicines audit, and checking staff recruitment files for completeness.

The provider was very responsive in taking actions to address the issues we found on inspection however we could not fully assess the impact of these actions until they were fully embedded.

People were safe and protected from abuse. All people spoken with told us they were safe and well cared for. There were enough well trained and well supported staff to ensure people’s needs were met. Risks to people’s health and well-being were clearly identified and care plans set out what support the person needed in the way they wanted their care to be provided. The provider’s policies and procedures had been revised in the light of the Covid-19 pandemic and staff had received relevant training and had access to appropriate personal protective equipment (PPE) in accordance with government guidelines.

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. Staff were engaging and showed skill and sensitivity in the way they responded to people. We saw staff consistently seeking consent from people in the process of offering care and support. The dining experience was relaxed, pleasant and sociable. People were offered a varied and nutritious diet and praised the quality of food served for variety and presentation. A visiting relative said: “The food is excellent (relative) loves it plenty of choice and variety”. The design and layout met the physical needs of people living at the home. Technology and equipment was available to meet people's care and support needs.

We could see from our observations that people were involved and treated with compassion, kindness, dignity, and respect. The people who lived at the home, and visiting relatives were unanimous in their praise for the staff and the standard of care provided. One person said: “The home is very good I’m treated with respect, very well looked after I would say". A visiting relative told us how moving to the home had positive outcomes for their loved one. They said “Here (at Elworth Grange) the focus is on the whole person not just their physical care needs”.

The atmosphere in the home throughout the inspection was welcoming and sociable. People’s care was tailored to their individual needs and outcomes were good. People were supported to take part in a range of hobbies and interest that met their individual needs and personal preferences. Staff clearly understood the importance of supporting people to develop and maintain relationships and where appropriate involved families, and other advocates in care and support planning processes. People received care that reflected their needs, characteristics, and personal preferences. Health and social care professionals spoke highly of the standard of care provided.

The management team were open and transparent throughout the inspection and responded to any requests positively. People who lived at the home, their relatives, and staff told us that all members of the management team were approachable, supportive, and always responded effectively to solve problems and improve the service.

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

Rating at last inspection

This service was registered with us on 01/05/2020 and this is the first inspection.

Why we inspected

We received concerns in relation personal care, nutrition, staffing and management. As a result, we undertook a comprehensive inspection. The overall rating for the service has been assessed as requires improvement. This is based on the findings at this inspection.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified a breach of regulations in relation to governance and records at this inspection. Please see the action we have told the provider to take at the end of this report.

Prompt action was taken by the registered provider during the inspection to mitigate risk and improve the quality of care in response to the concerns we found during our inspection.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection program. If we receive any concerning information we may inspect sooner.

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