CQC report explained · a nursing home
What the CQC found at Elm View Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2019
Elm View Care Home was rated Good; inspectors found kind, safe care, but noted waits for call bells and some missed individual needs.
Inspectors visited over three days. The first day was unannounced. They spoke with people, staff and relatives, observed care, and checked care records, staff files, medicines, complaints, incidents, training and management records.
They found that people were generally safe and treated with kindness. Medicines were managed safely, care plans were personalised, staff supported people's choices, and health professionals were contacted when needed. The home was clean and people could take part in activities and community links.
There were some shortfalls. People sometimes waited for call bells, one person's meal was not prepared as their care plan required, some staff had not received supervision as planned, and people staying in bed had limited one-to-one social stimulation. The overall rating was Good, an improvement from Requires Improvement at the previous inspection in November 2018.
Safe medicines
Medicines records were accurate and up to date. Staff had clear instructions for medicines given when needed and for people's diabetes care.
“People's medication administration records (MARs) were accurate and up to date.” from the report
Kind care
People and relatives generally felt staff were kind and caring. Inspectors saw staff speaking politely and respectfully with people.
“People and relatives felt staff were kind and caring.” from the report
Personalised care plans
Care plans included people's hobbies, family information, routines, medical histories and preferences. People and families were invited to regular care plan reviews.
“People's care plans were personalised and individual. They included people's hobbies and family information.” from the report
Clean environment
Inspectors found the home clean and without unpleasant odours. Staff understood infection control and used protective equipment when required.
“Staff had a good knowledge of how to handle and wash laundry. The home was clean and odour free.” from the report
Quality monitoring
The registered manager used audits and an action plan to identify improvements. Senior managers also monitored incidents, medicines, falls, infections and other risks.
“An action plan was in place that identified shortfalls that required improvements to be made.” from the report
Call bell waits
needs fixingSome people waited longer than expected for help at busy times. Inspectors found occasions when people waited between 10 and 20 minutes, including one call that took over 13 minutes to answer.
“We did find on occasions people were waiting for between 10 and twenty minutes before support was provided.” from the report
Individual meal support
needs fixingNot everyone received lunch in line with their individual requirements. One person did not have the plate guard or food preparation recorded in their care plan, which affected how much they ate.
“Not everyone received their lunch time meal inline with their individual requirements.” from the report
Staff supervision
needs fixingSome staff did not receive supervision as often as the provider's policy required. The provider planned further supervision sessions.
“Staff were not always receiving supervisions inline with the providers supervision policy.” from the report
Limited stimulation in bed
needs fixingPeople who spent a significant amount of time in bed had limited social stimulation. Inspectors said some could have benefited from one-to-one support.
“There was limited social stimulation provided to those who could benefit from one to one support whilst being cared for in bed.” from the report
Staff concerns
needs fixingSome staff felt management did not always address issues they raised. The staff survey also showed that 37% felt unable to challenge how things were done.
“The feedback confirmed 37% staff felt unable to challenge the way things are done at the service.” from the report
- 01How quickly are call bells answered now, especially at busy times and weekends?
- 02Have the three staff vacancies reported at the inspection been filled, and when is agency staff used?
- 03How do you check that each person's meal is prepared and served according to their care plan?
- 04Are all staff now receiving supervision at least four times a year, as required by the provider's policy?
- 05What one-to-one activities or social contact are available for people who spend much of their time in bed?
This was a planned inspection covering all five CQC questions and both the premises and care provided; all five ratings were given, with Safe and Well-led improving from Requires Improvement to Good. This explanation was written from the published report of 31 December 2019 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, November 2018
Rated Requires Improvement; inspectors found kind, person-centred care, but care records, thickener storage and quality checks were not always reliable.
Inspectors visited without warning on 20 and 21 September 2018. They spoke with people living in the home, visitors, managers and staff. They reviewed care records, staff files, medicines information, complaints, incidents, training and audits.
The home was rated Requires Improvement overall. Safe and Well-led were Requires Improvement. Effective, Caring and Responsive were Good. The previous overall rating had been Good.
Inspectors found people were generally happy and felt safe. Staff were described as kind and caring, and people had choices about food, activities and daily routines. However, records about wounds, nutrition, diabetes and repositioning were not always complete or up to date. Thickening agent was also not always stored safely, and the provider's checks had not found all these problems.
Kind and respectful care
People and relatives were very positive about staff. Inspectors observed staff treating people with dignity, protecting privacy and using positive interactions.
“People and relatives felt supported by staff who were kind and caring and all were very happy with the support they received.” from the report
Staff training and support
Staff received regular supervision, appraisals and training. This included additional training for some people's specific needs.
“People were supported by staff who had training to ensure they had the skills and competence for their role.” from the report
Choice and activities
People could choose when to get up, go to bed, eat and take part in activities. There was a range of activities, including arts and crafts, poetry, singing and films.
“People had access to a variety of activities.” from the report
People's views were heard
Residents' meetings and surveys were used to gather people's views. The report gives examples of suggestions that led to changes.
“People told us, "I find the residents' meetings useful, the manager does listen and take notice".” from the report
Care records were incomplete
seriousSome records did not clearly show current needs or the care given. This included wound care, nutrition, diabetes monitoring and repositioning.
“People's care plans did not always have up to date records relating to the person's wound management.” from the report
Thickener was not always stored safely
seriousThickening agent was seen in people's rooms where it was accessible. There was no written risk assessment explaining how this risk was being managed.
“People who required a thickening agent adding to their fluids, did not always have this stored safely.” from the report
Mixed views about staffing
needs fixingSome people said they waited too long for call bells and thought more staff were needed. Staff and managers said staffing was enough and that call bell times were reviewed.
“Another person said, "Should be more staff; bell usually answered in 5 minutes but can be 25 minutes".” from the report
Quality checks missed problems
seriousThe provider's audits had not identified all the incomplete records and storage problems found by inspectors. One required notification to CQC had also not been made.
“The providers quality assurance system had not identified shortfalls found during the inspection.” from the report
Distractions during medicines rounds
needs fixingA telephone on the medicines trolley rang while medicines were being given. Inspectors said this did not follow the provider's own policy about avoiding interruptions.
“This meant any interruptions could potentially lead to the member of staff becoming distracted.” from the report
- 01What changes have been made to ensure wound care, nutrition, diabetes and repositioning records are complete and up to date?
- 02How is thickening agent stored now, and what written risk assessment is in place?
- 03What are the current call bell response times, and how are staffing levels adjusted when people’s needs change?
- 04How do you prevent interruptions and distractions during medicines rounds?
- 05How do your audits now check that care records and required CQC notifications are complete?
This was an unannounced inspection covering all five questions; Effective, Caring and Responsive remained Good, while Safe and Well-led fell from the previous Good rating to Requires Improvement. This explanation was written from the published report of 23 November 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.
Every inspection of Elm View Care Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- December 2012
Registered with the Care Quality Commission on 7 December 2012.
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
23 live-in carers within about an hour of North Somerset
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 £1,050 to £1,320 a week. 19 can care for a couple. 12 years' experience on average.
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.