CQC report explained · a residential care home
What the CQC found at Elm Lea Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and assessed risks. Medicines were stored, given and recorded safely, and there were enough staff to meet assessed needs.
- Effective?
- Good
- People were supported to make choices, eat and drink well, and access healthcare. Staff received training, supervision and support.
- Caring?
- Good
- Inspectors found kind and caring staff who respected privacy, dignity and independence. People and relatives were involved in care planning.
- Responsive?
- Requires improvement
- Care plans were detailed and regularly reviewed, but people did not always have access to enough activities that met their needs, choices and interests.
- Well-led?
- Good
- The manager provided visible leadership and there was an open culture. Audits, meetings and feedback were used to monitor and improve the service.
What inspectors found, May 2018
Rated Good; inspectors found safe, kind and well-managed care, but activities did not always meet people's needs.
This was an unannounced inspection on 20 March 2018. Inspectors observed care, spoke with people, relatives and staff, and checked care plans, medicines, recruitment records and quality checks.
The home was rated Good overall. Safe, Effective, Caring and Well-led were rated Good. Responsive was rated Requires Improvement because people did not always have enough activities that matched their needs and interests.
The service had improved from Requires Improvement at the previous inspection in November 2016. Earlier breaches about medicines and quality monitoring had been put right by this inspection.
People felt safe
People told inspectors they felt safe. Staff understood safeguarding and risks were assessed with guidance in place.
“People felt safe living at the service. Staff protected people from the risk of harm or abuse and knew how to identify and raise safeguarding concerns.” from the report
Safe medicines
Medicines were administered by trained staff and records, storage and audits were in place. The previous medicines breach had been resolved.
“People received their medicines safely from staff that were trained in the administration of medicine and followed the provider's policy and procedure.” from the report
Kind, respectful care
Staff were observed to have positive interactions with people. Privacy, dignity, independence and family contact were supported.
“Staff were kind and caring. People's privacy and dignity was maintained by staff who promoted people's independence.” from the report
Improved management checks
The home had regular audits, staff meetings and feedback systems. The previous breach about monitoring service quality had been met.
“At this inspection we found that effective auditing systems were in place to monitor and improve the quality of the service that was provided to people, this breach was now met.” from the report
Limited activities
needs fixingPeople did not always have a range of activities suited to their interests. Inspectors saw that most people in the lounge were not engaged in activities, and recommended that more should be sourced.
“People did not always have access to a range of activities to meet their needs.” from the report
Some reported waits for help
minorPeople gave mixed views about staffing. One person and a relative said there could be delays, although inspectors observed prompt responses and judged staffing sufficient for assessed needs.
“I don't think there are enough staff. If I need to go to the toilet they can take far too long to come and help me.” from the report
- 01What activities are available now, and how are they matched to each person's interests and needs?
- 02How do you check that people who do not join group activities still have meaningful things to do?
- 03How quickly can staff usually respond when someone needs help with the toilet or personal care?
- 04How are 'as and when required' medicines and bowel movement records checked now?
- 05How are a person's wishes for end of life care recorded and reviewed?
This was an unannounced inspection of the overall service, covering all five CQC questions; it also checked improvements after the previous inspection's medicines and quality-monitoring breaches. This explanation was written from the published report of 22 May 2018 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, February 2017
Elm Lea Residential Care Home was rated Requires Improvement because medicines monitoring and quality checks were not reliable enough.
This was an unannounced inspection on 23 and 24 November 2016. One inspector spoke with people living at the home, relatives, staff, the registered manager and provider. They observed care, medicines, meals and activities, and checked the building and records.
The home was caring and responsive. People were treated with kindness and respect. Care plans were personal and kept up to date. Staff knew people well, and there were activities, outings, food choices and ways to make complaints.
The main concerns were medicines and checks on the quality of care. Staff did not record some people's bowel movements, so it was harder to know whether constipation medicines were working. Audits had not found these problems. The home had improved since the September 2015 inspection, but two legal requirements were still not met.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement. This means the home was meeting many people's needs, but important improvements were still needed.
Kind and respectful care
Staff treated people with warmth and protected their privacy and dignity during personal care and everyday conversations.
“We observed warm and kind exchanges. Staff were discrete and spoke to people quietly to remind them to use the toilet, which meant people's dignity was protected in communal areas.” from the report
Personalised support
Staff knew people's histories, preferences and routines. Care plans gave clear guidance about how each person wanted to be supported.
“Care plans gave staff a clear understanding of each person and were individually personalised to help staff to support people in a way they liked.” from the report
Staff training and support
New staff had induction and shadowing. Staff received ongoing training, supervision and appraisals, and inspectors found them competent and confident.
“Our observations found that staff were both competent and confident in delivering care.” from the report
Activities and choice
People could choose meals and routines. Activities included music, art, singing, quizzes and games, with one-to-one options when these suited someone better.
“Activities were wide ranging and included music, art and singing as well as quizzes and games.” from the report
Medicines monitoring
seriousRecords did not show people's bowel movements when constipation medicines were prescribed as needed. This meant staff could not reliably judge whether treatment was working or whether further help was needed.
“Staff did not keep records of people's bowel movements.” from the report
Quality audits missed problems
seriousThe home's audits did not identify the medicines and care-planning shortfalls found by inspectors. This limited the home's ability to improve safety and practice.
“Audits and checks were carried out each month by the registered manager or a nominated person but had not always been effective in identifying the shortfalls highlighted during our inspection.” from the report
Diabetes care planning
needs fixingThe home had diabetes care plans and arrangements for foot and eye care, but foot care was not clearly linked to diabetes needs or recorded in enough detail.
“Although arrangements were in place for foot and eye care to take place, foot care in particular was not specifically linked to diabetic care needs.” from the report
- 01How do you now record bowel movements and check that as-needed constipation medicines are working?
- 02What changes have been made to medicines audits since this inspection?
- 03How do you check that care-plan audits identify all health needs, including diabetes-related foot care?
- 04What action was taken in response to the two breaches of Regulations 12 and 17?
- 05How are staffing levels reviewed when people's needs change, especially overnight?
This was an unannounced comprehensive inspection covering all five rating areas, with observations of care, medicines, activities and meals and checks of records, staff files and the environment. This explanation was written from the published report of 28 February 2017 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 Lea Residential Care Home
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- May 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at Elm Lea Residential Care Home →
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Elm Lea Residential Care Home →
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- April 2013
Registered with the Care Quality Commission on 25 April 2013.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
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. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
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.