CQC report explained · a nursing home
What the CQC found at Elmcroft Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2023
Requires Improvement overall; inspectors found improving safety work but inconsistent person-centred care and weak management.
Inspectors visited on 6, 13 and 19 December 2022. They made two unannounced visits, spoke with people, relatives, staff and professionals, and checked care records, medicines, staff files and management records.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Inspectors found concerns about safeguarding, medicine oversight, staffing communication, complaints, people's daily wellbeing and personalised care.
There were also signs of improvement. Care plans and medicine practice were being revised, the environment had been refurbished, and a new manager had started. However, inspectors said improvement plans and checks had not always been effective or completed quickly enough.
The overall rating changed from Good at the previous inspection in 2019 to Requires Improvement. This was a focused inspection of three key questions, so new ratings were not given for Effective or Caring.
Improving medicine storage
The report says medicine storage had improved significantly, with renovated medicine rooms and new equipment.
“Storage of medicines had improved significantly. The medication rooms had been renovated and new equipment purchased.” from the report
Better care planning
Care plans and risk assessments were being revised to give staff better guidance about people's individual needs.
“There had been significant investment in revising people's care plans, and this was starting to improve the quality of the guidance to staff.” from the report
Activities and engagement
The activity coordinator's specialist training was helping some people take part in conversation and activities.
“The activity coordinator had been on specialist training and people benefitted from this.” from the report
Working with professionals
Inspectors found examples of the service working well with outside professionals to manage people's needs and improve medicine practice.
“Other professionals told us the service was working well with them to meet people's needs and make the necessary changes, such as improvement in medicine administration.” from the report
Personalised care was inconsistent
seriousPeople were not always supported according to their preferences and needs. Inspectors found concerns about food, clothing, communication, personal care and social contact.
“People were not always supported in a way that was personalised and met their needs and preferences.” from the report
Safeguarding concerns
seriousInspectors found that concerns were not always reported properly, including significant bruising after a fall.
“A safeguarding had not been raised when a person had significant bruising following a fall.” from the report
Medicine records did not match
needs fixingOn the inspection day, electronic medicine records and medicine stocks did not agree. The provider was using paper and electronic systems at the same time.
“On the day of our inspection the electronic records and medicine stocks did not tally.” from the report
Limited daily interaction
needs fixingSome people had little contact beyond care tasks. Staff did not always chat or engage with people, increasing the risk of loneliness and isolation.
“For significant periods of time, some people's only contact was with staff who carried out tasks with them.” from the report
Inconsistent infection precautions
minorInspectors were only somewhat assured that protective equipment was used safely because staff did not wear masks consistently.
“We were somewhat assured that the provider was using PPE effectively and safely. Mask wearing was not consistent among staff.” from the report
- 01How will you make sure each person's food, clothing, drink, communication and personal care preferences are followed on every shift?
- 02What has changed in the safeguarding process since the concern about significant bruising after a fall?
- 03How are you checking that electronic medicine records match medicine stocks now that the new system is being introduced?
- 04Who is responsible for checking people's quality of life and making sure activities and meaningful conversation happen each day?
- 05How are you recording and responding to informal complaints and involving families in care plan reviews?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward for the overall rating. This explanation was written from the published report of 4 February 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, May 2019
Rated Good; inspectors found safe, kind and responsive care, but the environment was not well adapted for people with dementia or sight loss.
This was an unannounced, planned inspection on 27 February 2019. Inspectors reviewed care and medicines records, staff files, complaints and management documents. They spoke with people, relatives and staff, and observed care.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, suitable recruitment checks, safe medicines systems, trained staff and care plans that reflected people's needs.
People were treated with kindness and respect. Staff knew people's preferences, supported their choices and helped them with food, drinks and healthcare. Complaints were handled appropriately and the management team used audits and feedback to improve the service.
The overall rating improved from Requires improvement at the previous inspection, published on 20 January 2018. Inspectors said the improvements requested after that inspection had been made.
Safe care
Risk assessments gave staff clear instructions for supporting people safely, while still promoting independence and choice.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Kind and respectful staff
Staff knew people well and supported them with patience, dignity and respect.
“People received individualised care and support from staff who were kind and patient.” from the report
Staff training and support
Staff had induction, training, regular supervision and annual appraisals. A clinical lead had also been appointed since the previous inspection.
“Staff were well-trained and worked together as an effective team.” from the report
Good communication
Relatives were kept informed about events such as falls and ambulance calls, and were involved in care planning.
“They are good at communicating, they have rung me each time [relative] has had a fall, and if the ambulance has been called, they've let me know.” from the report
Dementia and sight-friendly environment
needs fixingThe corridors had neutral colours, unsuitable signs and few items of interest. Inspectors recommended looking at good practice guidance, and the provider had an improvement plan in progress.
“The overall environment was not well adapted to people living with dementia or those with sight impairments.” from the report
End of life care plans
needs fixingSome care plans recorded where and how people wished to receive end of life care, but this information was missing from others. The management team said it was reviewing the records.
“Some care plans contained information about how and where people wished to be supported if they needed end of life care but it was not recorded in all care plans.” from the report
- 01What changes have been made to the corridors, signs and other areas for people living with dementia or sight impairments?
- 02How do you make sure every person's wishes about end of life care are recorded and kept up to date?
- 03How many staff are normally on duty for the needs of the people living here, including at night?
- 04How are staff trained and checked to support people with dementia, complex health needs and medicines?
- 05How will relatives be told about falls, ambulance calls or other changes in a person's health?
This was an unannounced planned inspection that looked at the overall service and all five CQC questions, including both the premises and the care provided. This explanation was written from the published report of 8 May 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.
Every inspection of Elmcroft Care Home
7 rated inspections over 8 years: the service has improved, from Inadequate to Requires improvement.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2019Goodup from Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- January 2018Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2015Goodup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2015Inadequatestayed InadequateWell-led: Requires improvement
- February 2015InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- September 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 January 2011.
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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