Elcombe House

We found the following examples of good practice.

Systems were in place to support safe visiting to the service. All visitors were subject to a range of screening procedures, these included providing evidence of a negative lateral flow test (LFT), completing a COVID-19 questionnaire and having their temperature taken. Professionals visiting people at the home had to show their COVID-19 vaccination passes or show proof of their exemption.

People living in the care home and staff were tested regularly for COVID-19. Staff had been vaccinated against COVID-19.

Staff wore personal protective equipment (PPE) correctly. The care home provided PPE for all visitors to the site, ensuring that everyone was protected from the risk of cross contamination. Hand sanitiser was readily available throughout the home; and there were also hand washing facilities. Staff had received training on PPE and infection prevention and control (IPC).

The care home looked clean and there were no malodours. Communal areas were well spaced and people, with the support from staff were encouraged to maintain social distancing.

People had been supported to have visitors come to the care home in line with COVID-19 visiting guidance. The service had converted one of their bedrooms into a visiting pod where a screen had been installed to support safe visiting. When face to face visits were not able to go ahead the service supported people to maintain contact with friends and family through use of the telephone and video calls.

Elcombe House is a residential care home providing personal and nursing care to 22 people at the time of the inspection. The service can support up to 23 people. The service had been designed to support people living with dementia or physical disabilities. People had their own bedrooms and shared communal areas such as a dining room, a lounge, bathrooms and a garden.

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

Without exception, people and their relatives told us they received exemplary support at Elcombe House. One person told us, ‘‘It is fantastic here. The staff are so wonderful and [support] could not be better.’’ A relative said, ‘‘I do not have the words to explain Elcombe House. They are exemplary in every area and exceed all expectations.’’

Everyone told us how dedicated, caring and supportive the staff team were and the positive impact these caring relationships had upon them. Staff had a passion for their job roles and this was reflected in the support which they gave to people. There was an extremely positive atmosphere at the service which promoted compassion and care. Staff had developed meaningful relationships with people and treated them with kindness and respect. Promoting people’s dignity, privacy and independence was a top priority for all staff members.

People received incredibly personalised care because of the effort made to get to know them as individuals and to support them in line with their preferences. The management and staff team were exceptionally responsive to people’s changing needs to ensure that they were able to stay in control of their lives and make choices about their support. People took part in a wide range of stimulating activities depending on their likes and dislikes. People were encouraged to speak about any concerns and these were used to improve the service where this was necessary.

The registered manager and staff team worked hard to ensure that people received high quality, effective care and achieved good outcomes. Best practice and innovations were used to improve people’s quality of life and well-being. The impact this had for people was clear to see. The number of falls for people who were at risk had reduced, people at risk of malnutrition had put on weight and were eating well and people did not have any pressure sores.

Staff training was very successful at giving staff the skills to understand and support people effectively. Promoting a healthy diet was a key value at the service and people were well supported in this area. Collaborative working with health agencies was central to people’s support and the outcomes they achieved.

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 kept safe from harm and abuse by systems in place at the service and risks to people had been thoroughly assessed. There were enough staff to support people safely and staff were recruited safely. People were well supported with their medicines and the service was clean as good infection control measures were implemented.

There was a positive, open and inclusive culture and atmosphere at the service. Staff were supported to be involved in the running of the service to achieve good outcomes for people. People living at Elcombe House benefitted from management and staff sharing a strong set of values which put people at the centre of their care.

Robust quality monitoring was used to identify areas for improvements and take actions to continually improve people’s experiences. People, relatives and the staff team were encouraged and enabled to work together to feedback about and shape the direction of the service.

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 11 May 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.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current best practice when supporting people. They were supported with regular supervisions.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professional when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaint had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Further information is in the detailed findings below.

Risk assessments had been completed to monitor people's ability to maintain an adequate dietary intake. Where people required specialist intervention then referrals were made to the NHS teams for advice and support. These relationships were built upon so that healthcare professionals were available to provide support to the people and staff.

We found that the required records were completed, were accurate and kept updated. These records were kept secure and staff demonstrated that they understood about the need to keep personal data confidential.

We spoke with two relatives visiting the service they said that they were pleased with the care delivered to their family members. One said "We just wish she had come here sooner. The care is good."

We spoke with staff who told us that it was mainly senior staff who administered medication but on occasions care staff would give out medication. All staff who administered medication had been trained to do so before they carried out this role.

Staff said they felt supported in their role and found the manager approachable. Staff also told us that they had received training in areas such as medication administration, Safeguarding of Vulnerable Adults and dementia care.

The provider had a complaints policy should it be necessary. We spoke with two relatives who said "We would go straight to the manager; she is very good. Anything we have raised has been dealt with straight away."