Background to this inspection
Updated
11 August 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.
Two inspectors and an Expert by Experience carried out the inspection. 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
Elliott House is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before 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. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We met with ten people who used the service and seven relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with ten members of staff including care workers, deputy manager, registered manager and provider.
We reviewed a range of records. This included people's care records and medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
11 August 2022
About the service
Elliott House is a residential care home providing personal care for up to 54 people aged 65 and over and living with dementia. At the time of the inspection the service was accommodating 42 people. The care home accommodates people in one adapted building set out over two floors. All but six bedrooms had ensuite facilities.
People's experience of using this service and what we found
Audits took place to ensure the quality of the service was maintained. However, these were not always robust and had not always identified where improvements were needed. Some risks to people had not been identified through the provider's own systems. This placed people at risk of harm.
Care plans and risk assessments were being updated so they identified people's support needs. Staff had a good understanding of the support people needed.
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. However, the system in place for the oversight of the Deprivation of Liberty Safeguards (DoLS) needed improvement so applications to renew, were made in a timely way.
Staff were kind and caring and understood their responsibility to report any concerns about people's health and well-being.
On the day of our inspection there were enough staff available to maintain people's safety and respond to their requests for support. Medicines were stored, managed and administered in line with good practice.
Feedback about the service, from people who lived at the home and those close to them was positive. People and relatives praised the staff and the management of the home.
The registered manager and provider understood their responsibilities under the duty of candour.
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 29 November 2019)
Why we inspected
This inspection was prompted by a review of the information we held about this service. This included an increase in information received about concerns with people’s care.
At this inspection we looked at the key questions of safe, effective and well -led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
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 have found evidence that the provider needed to make improvements. Please see the safe, effective and well led key sections of this report.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to providing safe care to people and good governance.
Please see the action we have told the provider to take at the end of this report.
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.