Eleanor Palmer Trust Home

Updated 19 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector and 2 Care Quality Commission specialist advisors who were a nurse and a pharmacist. The inspection was also supported by 2 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. 1 Expert by Experience spoke to people and relatives during the inspection site visit and the other Expert by Experience contacted people's relatives by telephone to request their feedback.

Service and service type

Eleanor Palmer Trust Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 6 relatives. We spoke with the Chief Executive Officer (CEO), registered manager, quality and compliance lead, administrator, clinical lead, activities organiser, 1 team leader, 4 care assistants,1 domestic staff and 1 chef. We undertook observations of people receiving care to help us understand their experiences, especially for those people who could not talk with us.

We reviewed a range of records. This included 11 people's care records and 10 medication records. We looked at 5 staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, accident and incidents, training and quality assurance were also reviewed.

After the inspection we looked at more records and continued to seek clarification from the provider to validate evidence found. We spoke with 14 more relatives and friends of people living at the home over the telephone.

Updated 19 January 2023

About the service

Eleanor Palmer Trust is a residential care home providing personal and nursing care to up to 33 people. The service provides support to older people some of whom are living with dementia. At the time of our inspection there were 33 people using the service.

People’s experience of using this service and what we found

There had been management changes since the last inspection, which affected the overall service management. The provider had been working to improve the quality and safety of the service. They continued to work with the local authority quality assurance team.

The new registered manager was in the process of getting to know the service, introducing and establishing new systems and processes, and a clearer structure with more effective monitoring and accountability. However, these changes had yet to be fully established and embedded.

We found medicines were not always managed safely, which placed people at increased risk of harm. Systems and processes were not always in place to check people had received their medication safely. Medicines audits were not robust enough to check people were receiving their medicines as prescribed or that the service was managing medicines in line with national guidance.

People were supported by staff who had been checked to ensure they were safe to work at the service and there were sufficient staffing levels in place. People told us they did not have to wait long for staff support when using their call bells. Staff had received a range of training and development. Supervision to support and monitor practice was undertaken.

The staff team followed procedures and practices to control the spread of infection and keep the service clean. There was an emergency plan in place to respond to unexpected events. The premises were well maintained, and some areas were being refurbished to meet the needs of people living at the service.

People were safe living at the service and relatives felt their family members were kept safe. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. They felt confident issues would be addressed appropriately.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were able to access healthcare professionals such as their GP. The service also worked with other health and social care professionals to provide effective care for people. People were supported to access appropriate food and fluids and meals were described as being good.

People told us they were happy with the care they received, and staff were kind and helpful. People's choices were considered when providing care and their views were considered. Staff had a good understanding of people as individuals and people were treated with dignity and respect.

Relatives felt the management of the service was improving and that they could approach the registered manager and staff with any concerns. Staff felt the management was open with them and communicated what was happening at the service and with the people living there.

Improvements to audits and management oversight of the service were being put in place by the registered manager and these needed more time to have a positive impact on the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published on 18 November 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found some improvements had been made but the provider remained in breach of one regulation, related to the management of medicines. We have also made a recommendation in relation to sustaining the overall improved standards.

At our last inspection we made a recommendation about making adaptations to the home, person centred care planning and managing complaints. At this inspection we found the provider had acted on the recommendations and they had made improvements.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection and addressed the issues set out in the Warning Notice.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eleanor Palmer Trust on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.