Elmhurst Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. This is the first assessment for the newly registered provider of this service. This key question has been rated inadequate. This meant services were not planned or delivered in ways that met people’s needs. The service was in breach of legal regulations in relation to person-centred 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 were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs. The provider failed to implement person-centred care through the lack of detail in care documentation specific to people’s needs, wishes and preferences. Where people’s care needs had changed this was not always updated or reflected in people’s care plans or risk assessments. Staff told us people did not have control or choice over their own care and treatment, and people’s care plans were not always up to date or accurate.

There were significant shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not joined-up, flexible or supportive of choice and continuity. Despite the service mainly supporting older people with physical health needs and/or living with dementia, relatives and staff told us the service did not fully understand the needs of this group of people and the training provided was basic. Staff informed us of routines implemented in the service which was not supportive of people with dementia. We saw no evidence of people's differences or diverse needs being documented or promoted through care records in the service, and no clear links were formed for people in the service with external communities.

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Care plans were not readily shared with people or relatives, and they were not up to date or accurate in the information they contained. Further to this we received information of concern regarding the provider informing some relatives they had to pay to see their family members care plans, which was not agreed in the contract and against consumer laws.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not involve people in decisions about their care or tell them what had changed as a result. Some people and relatives’ concerns and complaints had not been listened to, taken seriously, recorded, investigated, or appropriately responded to. The provider did not have an effective and accessible system in place to record, manage, investigate and monitor complaints and concerns. We did see some feedback surveys had been completed by some people, but this feedback had not been collated or analysed. There was therefore no evidence of action taken in response to the feedback. We did not see any documentation to show relatives had been involved in meetings or in an official feedback process. Staff told us they could not provide open, honest feedback to improve the quality of care, out of fear of the repercussions from the provider.

The provider did not make sure people could access the care, support and treatment they needed when they needed it. We saw evidence of referrals to GPs and district nurses for people in the service. However, some relatives felt the need to have external professionals provide assessments on their family member’s needs, and some external stakeholders provided feedback they felt the service was being obstructive in ensuring assessments could take place for people who may need additional support from specialist services.

Staff and leaders did not listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this. For example, one person who had a diagnosed mental health illness did not have their care or support tailored in line to meet their unique requirements. No adjustments had been made to accommodate the person’s needs and the care plan was basic meaning staff did not have clear guidance on what this condition was like or how it may affect the person. Staff did not have the training to understand this condition.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. At the time of assessment no one was actively receiving end-of-life care. We did see some care plans had advanced care decision booklets in place but no end-of-life care plan in place because of not being at that stage. We could not be assured end of life care plans would be detailed, specific or person-centred due to the shortfalls in the rest of the care plans. Staff had received training in end-of-life care.