New Elmcroft

Updated 27 May 2022

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 Care Act 2014.

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

The inspection was carried out by two inspectors and an Expert 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.

Service and service type

New Elmcroft is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. The service had a new manager who had recently started working at the home having moved from another of the providers services. They had started the process to become the registered manager at New Elmcroft.

Notice of inspection

This inspection took place over two days. The first day was unannounced and the second day was announced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and information we had about the concerns. 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 11 people who used the service and one relative about their experience of the care provided. The Expert by Experience contacted eight relatives remotely by phone. We spoke with 16 members of staff including the manager, assistant manager, operations manager, quality improvement manager, registered nurses, team leaders, activity staff, care workers and the chef.

We reviewed a range of records. This included 10 people’s care records, multiple medication records and records relating to the management of the service. We looked at training information, quality assurance and audit documents and the providers policies and procedures. We looked at three staff files in relation to recruitment and staff supervision.

Updated 27 May 2022

About the service

New Elmcroft is one of a group of homes owned by a national provider, Shaw Healthcare Limited. It is a residential 'care home' which can accommodate up to 60 people in one adapted building. The care home provides accommodation and nursing care for people living with a range of healthcare needs and disabilities associated with older age and frailty, including people living with dementia. There were 46 people living at the home at the time of our inspection.

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

People did not always receive care in line with their assessed needs and plans of care. People did not consistently receive safe wound care as guidance from health professionals was not always followed to ensure risks to people’s health and safety were mitigated. People were not always monitored for changes to their health following a fall as staff had not always followed the provider's processes to keep people safe. Staff did not always have all the risk information required to ensure potential risks associated with people’s health conditions were managed effectively.

Systems to monitor the quality and safety of the service were not robust enough to identify shortfalls in people’s care, communication or records relied upon to demonstrate the care people had received. The service had a new manager who had begun to implement changes to improve the standard of care and overall governance of the home. However, these changes were not yet embedded or sustained and required more time to embed them in everyday practice and monitor their overall effectiveness to improve people’s care.

People’s and most relative's experience of using the service was positive. People told us they felt safe and were cared for by staff who knew them well and understood their needs. Staff understood their safeguarding responsibilities and knew how to escalate concerns. There were enough staff to meet people’s needs and changes made to the skill mix and deployment of staff, meant nurses had more time to provide care for people.

People and their relatives thought the home was clean and hygienic and people were protected from the risk of infection. Comments included, “The home seems clean and [person’s] room is well maintained”, and, “The home was clean when I visited before and staff were all wearing PPE, as did we as visitors.”

People received care that was responsive to their needs. People were offered choice and their preferences respected. 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’s communication needs were assessed, and people had access to information in the way they preferred when needed. People were offered a range of activities which would promote their emotional wellbeing and reduce the risk of isolation. People were supported to maintain contact with their loved ones and this continued if the home was closed due to COVID-19. One person’s relative told us, “The home arranged video calls at times when we couldn't visit.”

People received care and support at the end of their lives which was in line with their wishes and preferences. The managers acted on feedback and had taken action to enhance the quality of care people received at the end of their lives.

The managers of the service promoted a positive and person-centred culture which aimed to achieve good outcomes for people. Most feedback received was complimentary about the way the home was managed and the care people received. One person told us, “I enjoy it here, it is different from anywhere else and you know you'll have a good time. The staff are very good really, I have no problems at all.”

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

Rating at last inspection

The last rating for this service was Good (published 23 August 2018).

Why we inspected

We received concerns in relation to wound care, end of life care and infection prevention and control. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well led sections of this full report.

During and after the inspection, the provider took appropriate action to ensure any potential risks to people’s health and safety were mitigated. The manager provided assurance that concerns identified during the inspection, and others identified through their own quality assurance processes, would be addressed and actions taken to make the required improvements.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.