Background to this inspection
Updated
26 October 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team:
This inspection was carried out by one inspector, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Elm Lodge Residential and Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
This inspection was unannounced.
What we did before the inspection:
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection:
The inspector, the assistant inspector and the expert by experience visited the service on 27 September 2019. One inspector visited the service on 3 October 2019.
We spoke with 17 people who used the service and six relatives about their experience of the care provided. We spoke with three care staff, one registered nurse, the deputy manager, the activities coordinator, the cook, a domestic staff member, a maintenance staff member, a visiting health professional, the registered manager, the business support manager and one of the providers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included four people’s care records which included all aspects of care and risk including medication records. We looked at two staff files in relation to recruitment, staff supervision and training. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.
After the inspection:
The registered manager sent us further evidence in relation to training data and quality assurance records.
Updated
26 October 2019
About the service:
Elm Lodge Nursing and Residential Home is a residential care home providing personal and nursing care to 56 people and over at the time of the inspection. The service can support up to 64 older people or younger adults who may be living with a physical disability or dementia. Elm Lodge Nursing and Residential Home is a large building made up of three floors each of which has separate adapted facilities.
People’s experience of using this service and what we found:
People were not always engaged in meaningful activities for a sufficient amount of time. People told us that they were sometimes bored, and staff did not always have enough time to sit and engage with them in activities for a reasonable period of time. We have made a recommendation to the service about the provision of activities.
People were positive about the care they received. One person told us, ‘‘It is lovely here. The staff are so kind and caring and I would not have things any other way.’’
People were supported by a kind and compassionate staff team who had got to know people as individuals. People received personalised care that met their needs and there was an emphasis on knowing people’s likes, dislikes and preferences. People were involved in their care and able to make choices about how they were supported. People’s independence, privacy and dignity was promoted.
People were kept safe by as staff team that knew how to safeguard them from harm. Risks to people had been thoroughly assessed. People were supported safely because of policies and procedures in place at the service in all areas of their care including medication and infection control. There were enough suitable trained and competent staff to meet people’s needs safely.
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 were supported to eat and drink depending on their support needs in this area. People were supported to see health professionals and to live healthy lives.
People were supported in an environment that enabled them to be supported safely. The registered manager was making improvements to the premises to further improve people’s care and support. People had access to a complaints procedure and complaints were dealt with promptly and thoroughly. People were supported with dignity and respect at the end of their lives.
People and the staff team were positive about the management of the service. The registered manager completed audits to monitor the quality of the service and put improvements in place where these were necessary. People, relatives and the staff team were encouraged to feedback about the service. The registered manager and staff team worked with other organisations to ensure good outcomes for people.
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 requires improvement (published 5 October 2018). At this inspection we found improvements had been made and the service is now rated as good overall.
Why we inspected:
This was a planned inspection based on the previous rating.
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.