Archived: Elliott House

Updated 31 March 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 team consisted of three inspectors.

Service and service type

Elliott House 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.

The service did not have a manager registered with the Care Quality Commission at the time of the inspection. This means provider was 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 the inspection

We reviewed information we had received about the service since the last inspection. We met with the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and one relative about their experience of the care provided. Some people were not able to speak with us so we observed people’s care and the support provided by staff in the communal areas. We spoke with sixteen members of staff including the nominated individual, four interim managers, senior care workers, care workers, agency care workers, a cleaner and the chef. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We met with the nominated individual, the managers in relation to concerns we identified and the actions they planned to take to address these. We met with the local authority. We shared some concerns with the Kent Fire and Rescue Service. The provider informed us they had taken the decision to cease trading as a care home. People were supported to move to other services.

Updated 31 March 2022

About the service

Elliott House is a residential care home providing personal care to 46 older people at the time of the inspection. Some people living in the service had dementia. The service can support up to 65 people. The service was provided over 3 floors in one large adapted building. There was a secure area for people with dementia called Poppy wing on the ground floor.

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

People were at risk of harm to their health and wellbeing and there were concerns about the management of the service.

People’s safety had not been sufficiently protected. Risks to people’s health, safety and well-being were not always mitigated. Where people expressed their emotions though behaviours there was a lack of information for staff on how best to support people and not all staff knew about people’s risks. The environment was not safe for people. Trip hazards had not been addressed. People would not be safe in the event of a fire, there were items blocking exit routes. Items which could be harmful if accessed by people with dementia, such as razors, were accessible to people. Medicines were not well managed to ensure people received these safely and as prescribed by their doctor.

People were not kept safe from the risk of infection. The service was not clean. There were insufficient cleaning staff to keep it so. The provider was not able to evidence they had checked staff had received their covid-19 vaccinations or were exempt, as required. There was no evidence staff were regularly testing for covid-19 which increased the risk to people.

Incidents were not always reported, it was not clear what actions had been taken to reduce the risk of incidents occurring again. People were not protected from the risk of abuse as safeguarding concerns had not always been reported to the local authority or Care Quality Commission (CQC).

There were insufficient competent staff to provide people with safe and effective care. There were a significant number of agency staff and they had not all received an appropriate induction when they first started work at the service. Staff had not always been recruited safely to ensure they were suitable to work in care. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There was a lack of provider oversight of the service. Checks on the quality of the service had not been effective to keep people safe. The provider had failed to address concerns found at the last inspection. Staff told us they did not feel listened to and were not happy in their role. The service worked in partnership with other health and social care professionals however their advice was not always followed.

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 15 May 2019). We identified four breaches of Regulation. Regulation 12 (Safe care and treatment), 9 (Person-centred care), 10 (Dignity and respect) and 17 (Good governance).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

We received concerns in relation to staffing levels and the management of the service. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only. We reviewed the information we held about the service. Prior to the inspection no areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous inspections for those key questions were used in calculating the overall rating at 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.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elliott House.

Enforcement

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 have identified breaches in relation to people’s health and safety, staffing levels, safe recruitment, , safeguarding, good governance and notifying CQC of events as required by law at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.