Elmhurst Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for the newly registered provider of this service. This key question has been rated inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes. The service was in breach of legal regulations in relation to assessing needs and gaining consent to care.

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not ensure people’s care and treatment was effective because they did not check and discuss people’s health, care and wellbeing needs with them. We found a lack of involvement of people or relatives in people’s care plans. Most people and their relatives told us they were not sure if they had a care plan and if they did, had not contributed to it for a long time. One person told us, “I don’t think I have a care plan, no.” A relative told us, “I would think [relative] has one, but I don’t know though.” We reviewed 9 people’s care plans and found the care plans were either not up to date or accurate, and in some cases, they did not reflect the service users’ current needs.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. We found examples where the service had failed to adhere to best practice guidance which meant standards of care and people’s experience was below what was expected. Relatives told us this had a negative impact on their family members and the service had not always been responsive to people’s changing needs. Records showed some nationally recognised assessment tools were in place, but these had not always been used appropriately to assess and monitor people’s needs and risks. Relatives told us on occasions despite telling the service their family members care needs had changed, amendments to the care plan had not been acted upon.

The provider did not work well across teams and services to support people. They did not share their assessment of people’s needs when moving between different services. Professionals who work with the service told us the service did not work effectively with them or other external professionals. We saw in care records involvement of district nurses, GPs and also social workers however documentation on the visits was limited. One person was assessed by a private physiotherapist, however there was poor communication and partnership working with the professional, which meant guidance by the physiotherapist and social worker was not followed. When people moved into the service there was not always a robust handover of information, leading to one example of an unsafe admission. Staff confirmed they did not get the information from assessments or care plans, due to them lacking information. There was a clear divide between care staff and management which further led to the breakdown of effective teamwork.

The provider did not always support people to manage their health and well being, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Despite having an activity schedule, the home did not have regular opportunities, so people were left for long periods of time with no meaningful activity or encouragement to move or exercise. One person told us, “No we don’t really do things like that, I chat to people mostly” and, a relative told us, “I don’t think they do much.” A relative told us how their family member needed to mobilise and have regular exercise as part of their recovery, however they were concerned this was not happening.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. We found examples in the records which showed care was not being routinely monitored. Where people had lost weight there was no immediate action taken. We saw no referral to a GP or dietician, and the provider had not implemented monitoring of food intake. Some people told us they saw other professionals, inclusive of GPs, district nurses and chiropodist. However, feedback was mixed and some relatives informed us they had concerns other professionals were not being referred to in a timely way, when required. Staff also confirmed this and told us there were occasions whereby they felt the need to call another health professional for guidance or support, such as a GP or ambulance service. However, they state they were told not to do so by the provider.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. Staff told us they were aware of how to gain consent during care tasks, however, most staff also told us they were often encouraged to go against people’s choices and to not speak with family members. One staff member told us, “Staff are pressured into doing things against people’s wills, and it’s not person-centred.” Records showed consent forms were completed during the initial admission, but we failed to see involvement of people or relatives in the development and subsequent reviews of care plans and risk assessments.