Archived: The Elms Care Home

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who use the service, their relatives, the staff supporting them and from looking at records. We also took into consideration the action plan of local commissioning teams.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff could learn from events such as accidents and incidents. However when action plans were put in place no one monitored if suitable action had taken place.

Regular checks were not undertaken to ensure the environment was safe.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Only one application had needed to be submitted and proper policies and procedures were in place.

The service was not clean or hygienic in places. Equipment was not well maintained but some items had been serviced regularly. Therefore people were put at unnecessary risk.

Records were not kept in a safe and secure environment.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

People said that they had been involved in writing them. The majority of care plans had not been regularly reviewed but a system was now in place to complete the reviews.

People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely.

People told us they could express their views at meetings with staff on a one to one basis and by completing surveys.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People commented, "All staff are very good and very kind" and "I feel safe and am quite happy here."

People who used the service, their relatives, friends and other professionals involved with in the service attended meetings throughout the year. Where shortfalls or concerns were raised there was no record of when they had been addressed. People told us they felt their opinions were valued.

People's preferences, interests, aspirations and diverse needs had been recorded in the care plans we saw. Care and support had been provided in accordance with those particular people's wishes.

People received their prescribed medicines. Although some people told us this was sometimes delayed.

Is the service responsive?

People told us they could speak with staff each day and share their concerns. They told us staff acted quickly. Relatives told us they could speak with staff about their family member's needs, when that person could not make decisions for themselves.

Is the service well-led?

The registered manager at this location was on leave during our visit but a covering manager was giving support to staff. The covering manager was a registered manager from another location owned by Four Seasons.

The service worked well with other agencies and services to make sure people received their care in a joined up way but staff were not good at recording other professionals' involvement.

Staff told us they could voice an opinion but some felt this was not always valued. Staff were supported by regular supervision sessions or training.

There was no update information on whether everyone's needs had been assessed. Therefore the staff levels could not be accurately determined.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were not identified as being addressed.. As a result the quality of the service was not being monitored.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home.

We were present whilst lunch was taken. We saw appetising food was served. One person told us, 'I like the meals; they are always well presented and are pretty good.'

One member of care staff told us, 'We have good systems in place to monitor people's weight and their BMI. We also keep a close eye on how much people eat and drink.'

We looked around the home and observed a good overall standard of cleanliness.

Our conversations with staff showed infection control was given a high priority and there were clear procedures to follow.

We observed a member of staff administering medications in one unit of the home. We reviewed the medications administration records (MARs) and found them to be accurate.

We spoke with a unit manager who explained how the staff rotas were set up and how cover for holidays and sickness was arranged from within the team itself. One member of staff told us, 'We don't use agency staff; we are pretty good at covering each other.'

We found improvements had been made to the management of odour problems in the home. New carpeting and floor coverings had been provided and checks on the standard of cleaning were taking place more frequently. We spoke with people who used the service about the cleanliness of the home. One person told us, "It is a clean place." Another person said, 'They keep the home looking very nice, it's always very clean and tidy, no smells.'

Staffing arrangements had improved since our last visit. Overall, staff said moral had improved and they were satisfied with the staffing levels in place. We observed routines and found staff responded promptly to requests for support. One person who lived in the home said, 'I'm very well looked after, the care staff are really nice.' Another person told us,' Staff are very good, always come when you ring for them, no problems at all.'

People who used the service told us they were well cared for. One person said, 'I'm quite satisfied with everything, I've no complaints" and "I'm getting the care that I need." Another person we spoke with said, "I'm happy with the support and care I get, I know they keep records about the help I need but I'm not very interested in all that.'