Archived: Elmhurst Nursing Home

Updated 12 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 July 2017 and was unannounced. The inspection was conducted 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.

As part of the inspection we reviewed the information we held about the service, such as statutory notifications we had received from the provider. Statutory notifications are about important events which the provider is required to send us by law. We asked the local authority and Healthwatch if they had information to share about the service provided. We used this information to plan the inspection.

The provider, Claremont Care Limited, went into administration in February 2016. The administrators of the home have employed a temporary provider to manage the service on their behalf.

During the inspection, we spoke with 10 people who used the service and four relatives. We spoke with 11 staff which included the home manager, the clinical lead nurse, one nurse, five care staff, one domestic staff member and two kitchen staff. We viewed three people’s records which related to assessment of needs and risk. We also viewed other records which related to the management of the service such as medicine records, accidents reports and two staff recruitment records.

We observed care and used the Short Observational Framework for Inspection (SOFI). SOFI is specific way of observing care to help us understand the experience of people who were unable to talk with us.

Updated 12 August 2017

The inspection was carried out on 12 July 2017 and was unannounced.

Elmhurst Nursing Home is registered to provide accommodation with nursing care for up to a maximum of 37 people. There were 25 people living at the home at the time of our inspection, some of whom were living with dementia.

There was no registered manager in post at the time of our inspection. The service is required to have a registered manager. During our inspection, we met with the home manager who had applied to become registered manager of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

When we undertook our last inspection in January2017 we had concerns about the staffing arrangements and we issued a warning notice which required the provider to make the necessary improvements to improve people's quality of life. They submitted an action plan and we continued to monitor this. At this inspection we reviewed whether the provider had made the necessary improvements and we were assured they had.

At our last inspection January 2017, we found breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. We gave the service an overall rating of ‘requires improvement’. These breaches related to the provider's failure to provide person centred care; to deploy enough suitably trained staff; to ensure decisions made on people's behalf were made in their best interests and a lack of robust systems to drive improvements in the service . We asked the provider to make improvements and to send us an action plan of how they intended to address the shortfalls in care.

At this inspection, we found that provider had made significant improvements and was no longer in breach of the regulations.

There were enough staff effectively deployed to meet people’s health and social needs in an unhurried manner. The provider had safe recruitment processes in place to ensure potential new staff were suitable to work at the home before they started work there.

People felt safe living at the home as staff were available to support them when they needed help. Staff were aware to the risks associated with people’s needs and how to minimise them. Staff were knowledgeable about the different signs of abuse and would not hesitate to report their concerns.

People were supported to take their medicine as prescribed. Only staff who had received training in the safe administration of medicines and assessed as competent were able to give people their medicines. Staff monitored people’s health needs and arranged health care appointments as necessary.

People received care from staff that had the skills and knowledge to meet their individual needs. New staff received a structured induction and were supported by a mentor. Staff felt training opportunities offered were good and relevant to their roles and development needs.

Staff and management understood the principles of the Mental Capacity Act and supported people to make decisions about their own care. Where people were unable to make specific decisions themselves, these were made in their best interest to ensure their rights were protected.

People’s nutritional needs were routinely assessed, monitored and reviewed. People enjoyed the food and were supported to eat and drink enough to maintain their health.

People found staff to be kind and caring. Staff treated people with dignity and respect and enabled them to remain as independent as possible.

People were given choice and felt listened to. People received care that was individual to them and responsive to their changing needs. Staff knew people well and supported them to take part in things they enjoyed doing.

People felt confident and able to raise any concerns they had with staff or management. Complaints were dealt with in line with the provider’s complaints procedures. The provider encouraged feedback from people, their relatives and health care professionals to drive improvements in the service.

There was a positive working culture at the home where staff and management worked together as a team to deliver the vision for the service.

The provider had a range of checks in place to drive improvements in the service.