Elmwood Residential Home Limited

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

We identified 1 breach of the legal regulations. We identified a concern where care was not person-centred and had not been designed with the persons input, preferences or wishes. This placed them at risk of receiving inappropriate care interventions. Improvements were needed in designing end of life care plans. However, people were positive when explaining their experiences at the service. They felt care was delivered in a person-centred way and the feedback we received on activities was positive. People and their relatives felt listened to and said they were provided sufficient information by the staff and management team.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they received person centred care and did not raise any concerns, however we identified a significant issue relating to one person’s records that could have resulted in a highly unsuitable care intervention. On the day of the assessment, we were advised that one person was assessed as receiving end of life care. We were handed an end of life care plan that was completed that day. The plan was inaccurate in relation to their resuscitation status placing the person at significant risk of receiving life saving care against their wishes.

Staff understood the needs and backgrounds of the people they supported. They spent quality time with them. Staff told us the staffing levels within the service and the registered manager told us staffing had been increased. One staff member said, “Yes, I feel there is enough staff and we do get time to spend with the residents.” People were supported by the staff and service management to put their life journey onto the ‘These Hands’ display within the communal entrance foyer of the service.

People were seen receiving timely support and care specific to their needs and preferences. Some people we spoke with told us they preferred to spend their time alone in their rooms. We saw that staff respected this but still ensured they periodically checked on people’s welfare. People’s care records contained personal information about them for staff to understand them better.

People and relatives felt they had good communication with the service and were kept up to date about their care and support. Staff had time to speak with people and care plans had information about peoples’ communication needs. Relatives we spoke with were positive about the communication and felt they were provided the right information. One told us, “With [deputy manager] I can email at any point; I get a response the same day.” Another said, “We have had relatives and residents’ meetings; we have them regularly. We have a newsletter, there is a lot of information given to us.”

Staff understood people’s needs and communication preferences. As previously highlighted, the registered manager stated they were aware of the AIS but no person currently receiving care required additional support with communication.

People were asked for their views and there were regular residents’ meetings and opportunities for people and families to speak to management and staff. There were systems that ensured relatives who held a Lasting Power of Attorney for people who no longer had capacity to make certain decisions were appropriately consulted. Relatives did not raise any concerns about the level of communication they received from the service. Information was available about what activities were planned and we saw that other key information, for example information on the Deprivation of Liberty Safeguards was available for people in communal areas of the service.

People and relatives told us they felt they had good communication with the staff and management. We saw the provider and managers talking to people and their visitors and it was clear their was a positive relationship. People and their relatives told us they would feel happy to raise any issues with the service management and staff. One relative said, “It seems really well run. It seems resident orientated, they all seem very cheerful.”

The service management were available to speak with people and the relatives when needed. The management office was centrally located within the first floor of the service. We saw people and visitors speaking with the management team in the office during the assessment. On a day to day bases, staff knew peoples’ needs well and ensured any concerns were dealt with promptly.

People were asked for their views and there were regular residents’ meetings and opportunities for people and families to speak to management and staff. There were also processes to seek feedback by way of a survey. We saw the supporting minutes of some previous meetings. The minutes showed key matters about the service, for example staffing and activities were discussed. Additionally, people and their relatives had the chance to raise concerns or ask questions. Where things were raised, a proposal of how it would be resolved was communicated.

People’s care, treatment and support promoted equality and protected their rights. People were constantly encouraged to lead rich and meaningful lives. Care was fully personalised and in line with people’s preferences. People spoke positively of the care staff that supported them and felt as much involved as they wanted to be in planning their care and support. People commented they felt the service was well managed and they could provide feedback or raise issues if they needed to. One relative said, “Everyone being considerate, very friendly, nothing is too much trouble.”

Staff ensured that people received care when they needed it and in line with their wishes and preferences. Staff and service management ensured all of the people living in the service received equitable care and escalated concerns and referrals accordingly. Staff told us that the new registered manager has had a positive impact on people’s care delivery. One said, “It is good – is a lot more structured now [registered manager] has taken over and now everyone knows what they are doing which is also better for the residents as well.”

Care records showed that people’s information was personalised to them. Care records were regularly reviewed. The service worked with other health and social care professionals to meet people’s specific needs and identified outcomes. The processes in place showed that all of the people living at Elmwood Residential Home were treated and cared for as equals.

When we spoke with people and their relatives, no concerns were raised in relation to planning for the future. However, we found improvements were needed around people’s end of life care planning. People had up to date Treatment Escalation Plans (TEP) forms stating their wishes relating to care and treatment intervention if they became unwell, however many care records had no information about people’s end of life preferences.

The registered manager told us care records were limited relating to end of life care preferences because people or their relatives did not always like to discuss this, however there was no record showing this conversation had occurred. They advised that care plans would be updated to reflect where conversations regarding end of life arrangements had occurred.

The current process around end of life care was being reviewed to improve the information held by the service. During our assessment, we saw examples of processes where the service had supported people to move out of the service back into the community. The registered manager gave information on how this was planned and achieved working closely with other relevant healthcare professionals. The service also had a candle by the front entrance, which when lit indicated to others that a relative or friend was saying goodbye to someone at the end of their life. This was to ensure the appropriate respect and sensitivity was exercised.