Elderflower House Nursing and Residential Care Home

Elderflower House is a care home with nursing. Accommodation is over two floors including lounge and dining communal areas. The service can accommodate up to 37 people, some of whom are living with dementia. At the time of our inspection 29 people were using the service.

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

Risks to people were not always assessed and managed. Accidents and incidents and any environmental risks were analysed to identify themes and trends. Staff knew people well and understood their responsibilities to protect people from harm and abuse.

People were put at ease by staff who spoke to them reassuringly and respected their privacy and dignity.

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.

People’s medicines were managed in a safe way by staff who had training and were assessed as competent. The service was clean, and staff wore personal protective equipment which was available throughout the service. However, some of the bathrooms upstairs required work which had been planned.

There were enough staff with the right skills and experience to meet people’s needs. Staff were kind and caring and motivated to achieve good outcomes for people. People were supported to follow their hobbies and interests and to maintain relationships with the people important to them. Staff were flexible in their approach so care and support was person centred.

There was a clear management and support structure in place, people and staff were consulted and listened to. New quality monitoring and governance systems and processes were being implemented to drive improvements and identify risks. Staff worked with partner agencies, so people received all the care and support they required.

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 24 December 2020 and this is the first inspection.

Why we inspected

This was a planned inspection following registration.

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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service accommodates up to 37 people in a large detached property. At the time of our inspection there were 28 people using the service. The service specialises in the care of older people and those living with dementia.

We found the following examples of good practice.

When people had tested positive, they isolated in their own rooms and a sanitation station was placed outside their door. This ensured that staff had additional personal protective equipment and sanitiser readily available when caring for someone with COVID-19.

A system had been implemented to divide staff into two teams. These consisted of a red team and a green team. The red team supported people who had tested positive and required isolation and the green team worked with those who did not contract the virus. The staff used separate toilets and rest rooms. This ensured that cross contamination was reduced.

Staff had been trained in infection prevention and control, food hygiene and COVID-19. They had also been trained in hand washing and donning and doffing personal protective equipment. Staff were also assessed as to their competency with infection control practices.

A regular programme of testing for COVID-19 was in place for staff and people who lived in the service. This meant swift action could be taken if anyone received a positive test result.

We saw that cleaning took place throughout the day and when the domestic staff finished their shift, care staff continued to ensure that touch points were regularly sanitised.

Policies, procedures and risk assessments related to COVID-19 were up to date which supported staff to keep people safe.

There was a robust infection prevention and control audit in place. If there were any areas for improvement identified, there was a clear audit trail and information on how this had been followed up.

Professional visitors had a sign in sheet where it asked for lateral flow test result, temperature and vaccine status. Staff checked this on entry to the service.

There is a clear risk assessment in place for those who are more vulnerable the highest scored were advised to work from home or not with people using the service to reduce the risk of contracting the virus.

We found the following examples of good practice.

¿ There was clear guidance for visitors at the door and a booking system was in place for when visiting occurred. The service was using social media and video technology to keep people in touch with their families while the home was closed and planning the possibility of outside visits reoccurring.

¿ Staff checked in to work one at a time and went straight to a room to have a COVID-19 test before starting work. The room was cleaned between staff testing.

¿ People that had tested positive were isolated in their rooms and there were plastic trolleys outside rooms for storage of Personal Protective Equipment (PPE) and clinical waste bins inside the persons room to dispose of used PPE.

¿ Staff had other specific areas to change PPE and the manager performed spot checks to ensure staff were wearing the correct PPE.

¿ It had not been possible to zone areas of the home, so staff had been allocated to work in specific areas to avoid cross contamination.

¿ Rooms were not en-suite, so the service had designated separate toilets and bathrooms for people who were positive and people who were negative to prevent cross infection.

¿ Staff working with COVID-19 positive people also had separate toilets and break areas to other staff, to minimise the risk of cross infection. Kitchen staff were no longer taking meals into communal areas to reduce the amount of staff people came into contact with.

¿ Agency staff had been used when staff were self-isolating. The service obtained agency staff profiles to ensure they had suitable training and experience and block booked staff so they were not working in other locations.

¿ The service had a designated isolation lounge for one person who could not isolate in their room, this reduced the risk of them walking around the home.

¿ Chairs in other communal areas were socially distanced to minimise the risk of cross infection.

¿ The service had implemented increased cleaning and the service had a sanitising machine that was being using to clean rooms after use.

¿ People had their temperatures and symptoms of COVID-19 checked twice a day to identify changes early.

¿ Procedures were in place for staff to ensure uniforms were washed daily.

¿ The activity coordinator was providing one to one activities for people.

¿ The management team told us that they were impressed with the teams commitment to ensure people’s safety at a difficult time.