The Elms Nursing Home

Updated 8 February 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by 2 inspectors who visited the service and completed the site inspection and an Expert by Experience who contacted people and relatives by telephone. 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

The Elms Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Elms Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 18 January 2023 and ended on 27 January 2023 We visited the service on 18 and 25 January 2023.

What we did before the inspection

We reviewed the information we had received about the service, including the previous inspection report and notifications. Notifications are information about specific important events the service is legally required to send to us.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service about their experience of the care provided and 13 relatives. We spoke with 16 members of staff including members of the senior management team, the registered manager, the deputy manager, a member of the maintenance team, two chefs and care and nursing staff. We observed care being provided. We reviewed a range of records, including eight people's care records in detail, and 10 people's medicines records. Four staff files were reviewed in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, training, staff rota's policies and procedures were also reviewed. We received feedback from five health and social care professionals.

Updated 8 February 2023

About the service

The Elms Nursing Home is registered to provide accommodation for up to 48 people. The home provides both personal and nursing care support to older people including those living with dementia. The home also provides short term rehabilitation support for people. At the time of the inspection the home accommodated a total of 41 people.

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

People were happy living at The Elms Nursing Home and spoke positively about the care they received and the running of the service.

We received mixed views from people and relatives in relation to the staffing levels. However, throughout the inspection we observed staffing levels were appropriate to meet people's needs and staff were available to people and responsive to people's requests for support in a timely way. Following our feedback on people’s views about staffing levels, the management team agreed to investigate this. Recruitment practices were safe and effective.

Although people told us they were involved in their care, some of the feedback we had from relatives highlighted they did not always feel involved or included in people’s care and were not always updated of changes in people’s needs. This had been identified by the management team prior to the inspection and plans were in place to address this.

The home was clean and there was a homely, welcoming and happy environment. Environmental risks had been considered and acted on where required. There were up to date policies and processes for the management of infection, prevention and control and the provider, management and staff adhered to the latest government guidance.

People's care plans and risk assessments contained information about their needs and how these should be managed. People's health and wellbeing was monitored in line with information highlighted in their care plans and risk assessments.

Safe systems were in place in relation to medicine management and people received their medicine as prescribed.

People were protected from avoidable harm. 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 had received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role. People were provided with enough to eat and drink.

People's needs were met in a personalised way. Staff knew the people they supported well and had a good understanding of their needs.

People were supported to partake in a range of activities centred around their particular interests. There was a person-centred culture within the service.

The service worked in partnership with other agencies to aid joined up, person centred care provision.

Effective and robust quality assurance systems had been developed and implemented to continually assess, monitor and improve the quality of care people received.

Throughout the inspection the management team showed a commitment to wanting to provide people with person centred, safe and effective care. They were open, transparent and responsive throughout the inspection.

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 overall rating for this service was requires improvement (published 19 November 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. 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 due to the previous rating of the service. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Elms Nursing Home 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.