Archived: Elliott House Care Home

Updated 6 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 and 31 August 2017 and was carried out by two inspectors and two experts 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.

We gathered and reviewed information about the service before the inspection. The registered managers had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with other information we held about the service. We looked at previous reports and checked the notifications we had received from the provider. This is information about important events that the provider is required to send us by law.

During our inspection we spoke and spent time with 22 people, six people’s relatives and visitors. We made observations throughout the service, looked at how people were supported with their daily routines and activities and assessed if people’s needs were being met. Some people were unable to tell us about their experience of care at the service so we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered managers and 11 members of staff. We looked at eight people’s care plans, risk assessments and guidance. We looked at a range of other records including four staff recruitment files, the staff induction records, training and supervision records, staff rotas, medicines records and quality assurance surveys and audits.

We last inspected Elliott House Care Home in June 2016 when there was one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection the registered managers had continued to make improvements and all the regulations were met.

Updated 6 October 2017

This inspection was carried out on 30 and 31 August 2017. It was an unannounced inspection.

Elliott House provides personal care and accommodation for a maximum of 70 older people. Some people are living with dementia. The accommodation is across three floors and there is a separate part of the home for people with dementia, called Poppy unit. Elliott House is a large home set in extensive grounds. There is parking along the drive at the front of the home. At the time of the inspection 56 people were living at the service.

At our last inspection in June 2016, the home was in breach of one of the regulations regarding safe staff recruitment and there were some improvements needed to meet this. The provider sent us an action plan outlining how they would make the improvements. At this inspection improvements had been made to staff recruitment and there were no breaches.

At this inspection some other improvements were needed. In Poppy unit staff were responsive to people’s choices and when a person became unwell but this left insufficient staff support for people in the dining room to make sure they ate their lunch well and in a dignified way. The registered managers found a solution immediately we brought this to their attention by changing some of the staffing arrangements. Some of the language the staff used was not person centred and this needed improvement. The registered managers were aware of this training need and were addressing it.

People and their relatives were complimentary of the service and the registered managers. A person’s relative told us, “If I have to go in a care home, this one is one of the best.” Feedback we received from health and social care professionals was all positive.

There were two registered managers in post who worked together sharing the role between them and both were present at this inspection. 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.

People told us that they felt safe living at Elliott House. Staff understood how to protect people from the risk of abuse and the action they needed to take to report any concerns in order to keep people safe. Staff were confident to whistle-blow to the registered managers if they had any concerns and were confident appropriate action would be taken.

There were enough staff to keep people safe. Staff were checked before they started working with people to make sure they were of good character and had the necessary skills and experience to support people effectively.

Staff were trained to support people’s health and wellbeing, including specialist training to support people’s changing needs. Staff met regularly with the registered managers to discuss their training and development needs and the registered managers worked alongside staff some of the time. The registered managers addressed any issues if staff were not working as they should so that the staff team worked together effectively.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered managers and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Mental capacity assessments had been carried out to determine people’s level of capacity to make decisions in their day to day lives and for more complex decisions when needed. DoLS authorisations were in place, and applications had been made for renewal, for people who needed constant supervision to keep them safe. There were no unnecessary restrictions to people’s lifestyles.

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 supported this practice.

Each person had a care plan that included their preferences and all the information necessary to meet their individual needs. Risks to people were assessed and managed without restricting people. People were involved in the assessments and planning and staff had a good understanding of making sure people had the right support to make decisions and give consent to care.

People were supported to have a nutritious diet. If people were not eating or drinking enough their food and fluid intake was monitored. Referrals were made to health care professionals, such as dieticians, when required.

People were supported to keep well and healthy and if they became unwell the staff responded promptly and made sure that people accessed the appropriate services. People received their medicines safely and when they needed them, by staff who were trained and competent.

There were a variety of activities available to keep people occupied. People were enthusiastically joining in with a music and movement session, playing ball games or quietly reading, playing dominoes or colouring. Some people were not doing anything although they said they were quite happy. Another activities coordinator had been employed and they were in the process of developing the activities on offer, including arranging outings and outside entertainment.

People, staff and relatives told us that the service was well led and that the registered managers and staff team were supportive and approachable and that there was a culture of openness within the service. People were treated with kindness, patience and respect. People were given the right support to maintain their independence as much as possible.

The registered managers had created a clear direction for the home and improvements were on-going. There was a good quality monitoring system that was based on feedback from people, their relatives and representatives and feedback was requested from visitors including health professionals. The registered managers carried out checks and audits of the service and had an improvement and development plan for the services based on the feedback and outcome of their audits.

People and their visitors told us that if they had a concern they would speak to the registered managers or any of the staff. There was a clear complaints procedure and opportunities for people to share their views and experiences of the service.

Checks on the equipment and the environment were carried out and emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.

Services that provide health and social care to people are required to inform the Care Quality Commission, (the CQC), of important events that happen in the service. This is so we could check that appropriate action had been taken. The registered managers were aware that they had to inform CQC of significant events in a timely way. Notifiable events that had occurred at the service had been reported. Records were stored safely and securely.