Archived: Elmhurst

Elmhurst is a purpose-built care home providing accommodation and personal care for up to 61 older people. At the time of this inspection 58 people were using the service.

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

People and relatives said the care and support people received was safe. The provider ensured people were protected from the risk of harm or abuse. Risks to people`s well-being and health were assessed, and measures put in place to mitigate identified risks. The provider operated safe and effective recruitment practices. People, their relatives and staff told us there were enough staff available to meet people’s needs in a timely manner.

People’s medicines were managed safely, and people were satisfied with the support provided with their medicines. There were infection control procedures in place and the environment was clean with no lingering malodours. The registered manager demonstrated they took learning opportunities from adverse events and incidents.

Elmhurst is a purpose-built care home arranged over two floors. Equipment was readily available to support people to be as independent as possible. Assessments were completed prior to moving into the home to establish if people`s needs could be fully met. Staff received training, support and supervision to enable them to carry out their roles effectively. People said they enjoyed the food provided and were offered choice. Staff knew people well and were able to quickly identify when people`s needs changed and seek professional advice.

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 treated people with kindness and dignity. Relatives appreciated staff`s kindness and the attention they showed to people. People were encouraged and supported to be involved with their care choices. People’s care plans were person centred and supported staff with understanding people`s past, likes, dislikes and preferences. Visitors were made to feel welcome and there were no restrictions on visiting times.

People received care and support as they wished. Staff knew what people liked and offered people meaningful choices throughout the day. There was clear signage throughout the home so that communal areas, bathrooms and people’s bedrooms were easily identifiable for people and their visitors. People enjoyed a wide range of opportunities for social interaction. People were comfortable to raise concerns if they needed to and felt they were listened to and issues were resolved. When people were nearing the end of their lives action was taken to keep them as comfortable as possible and to remain at the service if this was their choice.

People said the registered manager was approachable and was seen around the home regularly. People, their relatives, external professionals and staff told us the home was managed well. The registered manager used the provider’s robust governance systems to help identify and resolve issues in the home. People had regular meetings to discuss the service and make suggestions about how the home performed. Feedback from people was used to help influence continuous improvement in the home. The registered manager had developed good working relationships with external health professionals ensuring people's social and health needs were promptly met and had developed relationships with local community groups to enhance people’s everyday lives.

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 Good. (published February 2017)

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.

Elmhurst provides accommodation for up to 61 people with residential and dementia needs. It does not provide nursing care. At the time of this inspection there were 55 people accommodated at Elmhurst.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

When we last inspected the service on 26 April 2016 we found that improvements were required in relation to the arrangements for activities and engagement in the home and how concerns raised with the management team were responded to. At this inspection we found that the necessary improvements had been made.

People felt safe living at Elmhurst. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines were managed safely.

Staff received regular one to one supervision from a member of the management team which made them feel supported and valued. People received support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.

People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.

The provider had arrangements in place to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.

There was a cheerful, open and respectful culture in the home and relatives and staff were comfortable to speak with the registered manager if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

Elmhurst provides accommodation for up to 61 people with residential and dementia needs. It does not provide nursing care. At the time of this inspection there were 55 people accommodated at Elmhurst.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

However, the registered manager was on sick leave at the time of this inspection and a registered manager from another Quantum Care service was providing interim support at Elmhurst.

When we last inspected the service on 19 December 2013 we found the service was meeting the required standards we inspected at that time.

People and their relatives told us that they felt people were safe living at Elmhurst. Staff and the management team were knowledgeable about safeguarding matters. Risks to people`s mobility and general safety had been identified and risk assessments had been developed detailing the measures to be employed to mitigate these risks. Our observations during the inspection confirmed that staffing levels in the home were appropriate to meet people’s needs. Staff members did not start to work at the home until satisfactory employment checks had been completed. There were suitable arrangements for the safe storage and disposal of people’s medicines.

People were supported to make meaningful meal choices and people were assisted to eat in a calm and unhurried manner. People received care and support from a staff team who were supervised and had the knowledge and skills necessary to provide safe and effective care. Staff asked people for their consent before they delivered all aspects of care. People’s health needs were well catered for.

People were complimentary about the care and kindness demonstrated by the staff team. Staff were knowledgeable about individual’s needs and preferences and people were involved in the planning of their care where they were able. Visitors were encouraged at any time of the day and people’s privacy was promoted. We observed sensitive and kind interactions between staff members and the people who used the service.

The arrangements for activities and stimulation in the home were reduced at the time of this inspection due to a member of the activity staff team being temporarily seconded into another role. The provider had arrangements to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. However, some relatives were not satisfied that concerns that had been previously raised with the management team had been listened to.

People who used the service, their relatives and staff members did not always find the registered manager to be approachable and supportive. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

During our inspection on 09 December 2013 we found that improvements had been made. We saw that the broken bathroom tiles had been replaced and three of the four kitchenettes had been refurbished.

We looked at three mechanical hoists that were used by staff to move people safely. We found that two of the three were clean however we noted that one was soiled with food detritus.

Relatives told us they were satisfied with the care and support provided for people living in Elmhurst. One person said, 'I chose the place and it has come up to my expectations, they are taking good care of [relative].' Another person praised the staff and management team for the way they were always made welcome whenever they visited the home.

Health care professionals said they were satisfied with the care provided for people. They told us that staff were responsive to instruction and requested guidance and advice if they had any concerns.

We found that the provider was not maintaining the appropriate standards of cleanliness and hygiene at Elmhurst.

The provider had a recruitment procedure in place which ensured that new staff did not start work until the required checks had been carried out.

A complaints procedure was in place, which explained to people how they could complain should they have the need to.

People told us they enjoyed some group tasting sessions that took place at the home. These were developed to encourage people to try new foods. People said these were really enjoyable and they had encouraged them to, "Try something new and I liked it!"

We looked at a sample of records relating to people who were at risk from poor nutrition and hydration. We found that the standard of recording had improved since our previous visit of August 2012. This meant that staff were monitoring people's intake of food and fluid to promote their health and welfare.