Elmhurst Intermediate Care Centre

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

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

This is the first inspection for this service since its registration with CQC.

This key question has been rated as Good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff worked in partnership with people, and where appropriate their relatives and carers, to plan care and respond to changing needs throughout their rehabilitation.

People told us they felt involved in decisions about their care and understood the goals they were working towards. Staff provided examples of reasonable adjustments, including flexible visiting arrangements and access to meaningful activities.

Care plans reflected people’s physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. Records we reviewed demonstrated that people were supported to understand their conditions, participate in care planning and contribute to decisions about their treatment and rehabilitation goals. Staff regularly reviewed care plans and adapted them in response to changes in people’s needs and progress.

We observed a person-centred approach during MDT, therapy sessions and routine care. Rehabilitation goals were agreed with people and focused on outcomes that mattered to them, such as improving mobility, increasing independence and returning home safely. Discharge planning commenced on admission and reflected each person’s individual circumstances, strengths and support needs. This ensured care remained personalised throughout their stay and supported people to achieve the best possible outcomes following discharge.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff worked with community services, social care providers and specialist teams to ensure people experienced coordinated care throughout their rehabilitation.

We observed effective multidisciplinary working and saw care was well coordinated between teams and services. Daily handovers and multidisciplinary discussions ensured people’s clinical, therapy, personal care and social care needs were reviewed and responded to promptly.

Leaders recognised that people accessing the service often had increasingly complex needs and organised services to respond flexibly to these changing demands. A GP regularly attended the service to review people, contribute to care planning and undertake medicines reviews, helping to ensure care and treatment remained appropriate to people’s needs.

People were admitted with clear rehabilitation goals and discharge planning commenced from the point of admission. Staff worked with people, families, carers and partner agencies to identify ongoing support requirements and ensure appropriate packages of care were in place before discharge. When people left the service, information was shared with their GP and other relevant services to support continuity of care.

The service was inclusive and took account of people’s individual needs and preferences. Staff supported people living with dementia and learning disabilities through personalised care planning and the use of patient passports and worked closely with families and carers to meet individual needs. Communication requirements for people with disabilities or sensory loss were discussed at handovers, helping to ensure care was delivered in a way people could understand and engage with.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff ensured people, their families and carers were kept informed about progress throughout their stay and were involved in discussions about care and discharge planning.

We observed a range of information available throughout the service, including safety boards, posters, leaflets and display boards. These provided information about health conditions, rehabilitation, treatment options, self-care, falls prevention and discharge planning, as well as signposting people and carers to local and national support services.

Specialist teams, including tissue viability services, produced targeted information to support best practice and improve people’s understanding of their care and treatment. Staff also had access to clinical guidance and standard operating procedures to support safe and consistent care delivery.

The provider complied with the Accessible Information Standard and adapted information to meet individual needs. Communication requirements were identified through assessment and care planning, and staff had access to interpretation and translation services where required. Patient passports and personalised care planning documentation were used to support communication with people living with dementia, learning disabilities or sensory impairments, helping to ensure people could participate in decisions about their care and rehabilitation.

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

We observed staff encouraging people to express their views and preferences and adapting care in response to changing needs. People and their carers told us they felt listened to and involved in planning their care, rehabilitation goals and discharge arrangements.

People were able to share feedback, ideas and concerns through a variety of routes, including the Friends and Family Test (FFT), compliments and the complaints process. Information on how to raise concerns was included in the service information provided to people and their carers. People and carers told us they would know how to raise concerns if required and were confident these would be responded to appropriately. Staff ensured people who raised concerns or complaints were treated fairly and protected from discrimination or harassment.

Managers used learning from concerns and complaints to improve the service. Staff were aware of the complaints process and could describe how concerns would be escalated and managed. The service had received no formal complaints in the 12 months prior to the inspection. Staff received feedback about complaints and actions taken, and learning was discussed through governance and staff meetings. We reviewed records which demonstrated that feedback from people and carers was used to support service improvement and maintain a person-centred approach to care.

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

People were admitted based on clear admission criteria and assessed for suitability before admission. The primary requirement for admission was that people were medically stable and able to participate in rehabilitation. There were no other restrictive criteria for accessing therapy and rehabilitation support, enabling people with a wide range of needs to benefit from the service.

The environment supported equitable access to care, with level access, accessible facilities and on-site parking for people, visitors and carers. Staff made reasonable adjustments for people with disabilities, cognitive impairment or communication needs and adapted care to reflect individual circumstances and preferences.

Staff worked closely with community services, social care providers and other healthcare professionals to support smooth transitions of care. Discharge planning began on admission and considered people’s ongoing health, therapy, personal care and social care needs. Staff continued to support people when they transferred between services, helping to ensure continuity of care and access to appropriate support following discharge.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

We observed a person-centred approach, with staff taking account of people’s physical, cognitive, emotional, social and communication needs when planning and delivering care. People and carers provided positive feedback about the care they received and told us they felt treated with dignity and respect.

Leaders demonstrated an understanding of the factors that could create barriers to accessing care and worked to ensure services remained accessible and inclusive. Staff recognised that some people required additional support to achieve the same outcomes as others and adapted care accordingly.

Staff made reasonable adjustments to support equitable outcomes and ensure people could participate fully in decisions about their care and rehabilitation. People living with dementia, learning disabilities or sensory impairments were supported through personalised care planning, patient passports and involvement of families and carers where appropriate.

Compliance with equality, diversity, inclusion and human rights training supported the delivery of inclusive care and helped ensure staff understood their responsibilities in promoting equality and reducing barriers to care.

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

Staff recognised the importance of early discussions about care preferences and routinely considered future care needs as part of admission, rehabilitation and discharge planning.

We reviewed records which showed people’s wishes and preferences were documented and shared appropriately with relevant professionals. Staff supported people to make advance decisions about their care where appropriate and ensured existing advance decisions were respected. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were completed and followed in line with people’s wishes.

Staff understood how to escalate concerns and seek additional support when a person’s condition deteriorated, or when end of life needs were identified.

Relevant healthcare professionals and partner services were involved in planning future care, particularly for people with complex needs. We saw evidence of multidisciplinary discussions that considered people’s ongoing health, therapy, personal care and social care needs.

Staff reported good access to specialist advice, including palliative care services, and worked closely with discharge and community teams to ensure care plans reflected people’s wishes and supported continuity of care following discharge. For example, staff described how one person’s discharge was delayed allowing adaptations and preparation work to be completed in their home environment. This ensured appropriate support was in place and enabled a safe discharge when they were ready to return home.