CQC report explained · a residential care home
What the CQC found at Elm House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2023
Elm House Care Home was rated Requires Improvement because safety and management systems were not reliable enough.
This was an unannounced focused inspection. Inspectors visited on 19 October 2023 and carried out inspection activity until 23 October. They spoke with people, relatives and staff, and checked care plans, risk assessments, medicines records, health and safety records, audits and staff files.
The home was rated Requires Improvement overall. Safe and well-led were rated Requires Improvement. Inspectors found gaps in safeguarding, risk assessments, staff recruitment and quality checks. They found no evidence of harm, but said people were placed at risk.
Effective was rated Good. People were supported with food, drinks, healthcare and activities. The home was clean and comfortable, and people and relatives spoke positively about the staff and atmosphere.
The previous overall rating was Good, published in July 2021. The rating fell because of this inspection's findings. The provider had already started some improvements, and CQC asked for an action plan and will monitor progress.
Medicines support
Inspectors found that people were supported to take medicines as prescribed, with useful guidance for staff.
“People were supported to take their medicines safely.” from the report
Food and drinks
People were supported to eat and drink healthily. The report records positive feedback about the meals and dietary support.
“My relative loves the meals and eats better than they did at home.” from the report
Clean and comfortable home
The home was described as clean, comfortable and homely. Environmental and fire safety checks were in date.
“The service was clean and comfortable and had a homely atmosphere.” from the report
Kind staff and positive atmosphere
People, relatives and staff gave positive feedback about the staff, managers and atmosphere.
“The staff are brilliant, they are kind and caring and like to have a good laugh.” from the report
Support with health
Staff worked with health and social care professionals and helped people attend appointments and live healthier lives.
“Staff worked with other agencies such as speech and language teams, district nurses and social workers to enable effective care.” from the report
Safeguarding training and incident learning
seriousNew staff had not received safeguarding training and existing staff refresher training was out of date. The home did not have a robust system to monitor concerns or make sure lessons were learned.
“New staff had not received safeguarding training, and refresher training for existing staff was out of date.” from the report
Risk assessments and falls
seriousSome risk information was not up to date. There was no clear falls procedure and no documented action after a fall, so inspectors could not be assured that risks were being managed properly.
“There was no policy regarding what staff should do following a fall, for example specific observations, and we could not see any documented actions that staff took when someone had experienced a fall.” from the report
Staff recruitment checks
seriousNot all required references and Disclosure and Barring Service checks had been completed in the three staff files examined.
“Not all necessary safety checks including references and Disclosure and Barring Service (DBS) checks had been made.” from the report
Quality monitoring
seriousAudits had not been completed for two months. Repeated information was recorded and there was no record of actions taken, limiting the home's ability to identify and fix problems.
“Although we saw audits were completed, for example medicines and environmental, these had not been completed for 2 months.” from the report
Staff training
needs fixingStaff did not receive formal training when they started, and refresher training for experienced staff was out of date. The provider had arranged electronic training and planned further face-to-face training.
“All refresher training was out of date for experienced staff and this was not monitored.” from the report
Medicine and consent records
minorStaff did not always record when prescribed creams and eye drops were opened. Consent forms were also not present in people's files, although consent was recorded in daily notes.
“Staff did not always record the time of opening for prescribed creams and eye drops.” from the report
- 01What changes have you made to risk assessments and your procedure after a fall?
- 02How do you now check that all staff have completed safeguarding and refresher training?
- 03Have all staff files been checked for references and Disclosure and Barring Service checks?
- 04How often are your quality and medicines audits now completed, and how do you track actions?
- 05How do you record the opening dates of creams and eye drops and obtain consent for care?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and ratings for uninspected questions were carried over from the last inspection. This explanation was written from the published report of 2 December 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2021
Rated Good; inspectors found kind, person-centred care and improvements since the previous Requires Improvement rating, but some medicines records were incomplete.
This was an unannounced focused inspection on 14 and 15 July 2021. Inspectors observed care, spoke with people, relatives, staff and healthcare professionals, and checked care records, medicines, staffing, recruitment and quality checks.
The home was rated Good for Safe, Effective, Responsive and Well-led. People said they felt safe and were treated kindly. Inspectors found enough staff, suitable training, improved risk management, clean premises, personalised care and a wide range of activities.
The previous inspection had rated the service Requires Improvement and found several breaches. This inspection found enough improvement for the home to meet the legal requirements. A small medicines-recording issue remained, and inspectors discussed this with the management team.
Kind and respectful care
People and relatives were happy with the service. Inspectors observed staff being patient, kind and reassuring.
“People and their relatives were happy with the service they received.” from the report
Personalised support
Care was arranged around people's choices, preferences and changing needs. Staff encouraged independence and respected equality and diversity.
“People's care and support was centred around their choices and preferences.” from the report
Enough staff
Records and observations showed that staffing levels were sufficient and flexible enough to meet people's needs.
“Records and observations showed there were enough suitably skilled staff to meet people's needs in a flexible way.” from the report
Activities and relationships
People had access to varied activities and were supported to maintain important relationships through safe visits.
“People had access to a wide range of activities which they enjoyed.” from the report
Medicine records
needs fixingSome handwritten medicine administration entries and disposal records were not witnessed consistently. The issue was discussed with management, and action was taken after the inspection.
“However, we found handwritten entries on the medicine administration records and disposal records were not always witnessed.” from the report
Sharing feedback actions
minorThe home sought feedback and acted on it, but inspectors suggested making the resulting actions clearer to people and staff.
“However, we suggested sharing and displaying the outcome or actions taken with people and staff.” from the report
- 01How do you now make sure handwritten medicine directions and medicine administration records are witnessed?
- 02How are medicines for disposal recorded and checked?
- 03What actions have been taken in response to feedback from people, relatives and staff, and how are these displayed or shared?
- 04How often are care plans reviewed when a person's needs change?
- 05How are activities matched to each person's interests and preferences?
This was a focused inspection of Safe, Effective, Responsive and Well-led; the report says the other key question ratings from the previous comprehensive inspection were used in calculating the overall rating. This explanation was written from the published report of 31 July 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Elm House Care Home
3 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- December 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2021Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- August 2019Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2018
Registered with the Care Quality Commission on 10 July 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.