CQC report explained · a residential care home
What the CQC found at Elmhurst Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People received medicines safely and there were enough staff to meet their needs. Some specific medical and care risks had not initially been assessed, but the required risk assessments were completed during the inspection.
- Effective?
- Good
- Staff had appropriate training and people received support with eating, drinking and healthcare. Inspectors said the home could do more to make the environment supportive for people living with dementia.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People and relatives said staff knew them well and involved them in decisions about their care.
- Responsive?
- Good
- Care plans reflected people's needs, choices and preferences, and activities and visiting arrangements supported relationships. Information about life histories and some end-of-life wishes was not fully recorded.
- Well-led?
- Good
- People, relatives and staff spoke positively about the management and communication. The home carried out checks and audits, but these were not formally recorded.
What inspectors found, November 2019
Elmhurst Residential Home was rated Good; inspectors found kind, safe care, with some records and quality checks needing better consistency.
This was an unannounced inspection on 10 and 11 October 2019. Inspectors spoke with people living in the home, relatives, staff and healthcare professionals. They reviewed care records, medicine records, staff recruitment files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were supported by enough staff, received medicines safely, and were treated with kindness and respect. Their care plans were personalised and regularly reviewed.
Inspectors found some shortfalls in record keeping. Some specific risks had not initially been assessed, although these were corrected during the inspection. Quality checks and audits were being done but were not always formally recorded. Information about people's life histories and end-of-life wishes was also incomplete.
Safe medicines
People received medicines on time and as prescribed. Records were complete, medicines were stored securely and staff were trained and assessed as competent.
“Medicine administration records were clear and complete. There were no gaps identified in recording.” from the report
Kind and respectful staff
Inspectors observed kind and compassionate care. Staff knew people well and respected their privacy, dignity and independence.
“We observed people to be well treated and supported by care staff in a kind and caring manner.” from the report
Personalised care
Care plans included people's needs, preferences and how they wanted to be supported. Plans were reviewed monthly or when people's needs changed.
“Care plans were detailed, person centred and gave information about people, their support needs and how they were to be supported with these.” from the report
Activities and relationships
People could take part in varied activities if they wished, and relatives and friends could visit at any time without restrictions.
“There were no restriction on visiting times and visitors were always welcomed.” from the report
Improved recruitment and safety checks
The home had addressed concerns from the previous inspection about recruitment checks and fire drill records. Staff files contained the required employment and identity evidence.
“The provider had made the required improvements to address these concerns.” from the report
Some risks were not assessed at first
needs fixingSome people's specific medical or care risks, including catheter use or behaviours that challenged, had not initially been assessed. The home corrected this during the inspection.
“However, we did find for some people, that some specific risks associated with people's medical and care needs had not been assessed.” from the report
Quality checks were not recorded
needs fixingThe manager said checks and audits were completed, but they were not formally recorded. This could make it harder to show what had been checked and what needed improvement.
“However, these checks were not formally recorded.” from the report
Incomplete personal and end-of-life information
needs fixingVery little information had been collected about some people's life histories. People's end-of-life wishes had also not always been included in an appropriate care plan.
“Although people and relatives preferences and wishes around their end of life had been requested, these had not always been recorded within the person's care plan.” from the report
Accident trends were not analysed overall
needs fixingIndividual accidents and incidents were recorded and discussed, but the manager was not completing an overall analysis to identify patterns and trends.
“However, the registered manager did not complete an overall analysis of accidents and incidents so that trends and patterns could be identified to support learning and development.” from the report
- 01How are risk assessments checked now, especially for catheter use and behaviours that challenge?
- 02Can you show me how your quality checks and audits are recorded and followed up?
- 03How do you collect and use each person's life history to tailor their care?
- 04How are people's end-of-life wishes recorded, reviewed and shared with staff?
- 05How do you analyse accidents and incidents to identify repeated risks or patterns?
This was an unannounced planned inspection covering all five key questions and both the premises and the care provided; the Safe rating improved from Requires Improvement at the previous inspection and the other ratings remained Good. This explanation was written from the published report of 7 November 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, May 2017
Rated Good overall, but Safe requires improvement because pressure ulcer reporting and some staff checks were not always handled properly.
Inspectors made an unannounced visit on 24 October 2016. They spoke with people, relatives, staff and a health and social care professional. They observed care and checked care records, medicines and staff files.
The home had improved since its previous inspection in December 2015. The environment was safer, risk assessments and care plans had improved, and records were more complete. Medicines were stored and given safely. Staff were kind, respectful and supported people with food, health care and activities.
Safe was rated Requires Improvement. Senior staff did not know that serious pressure ulcers should be reported as a safeguarding concern. Some Disclosure and Barring Service checks had not been renewed, and there had been a gap in weekly fire alarm testing. The other four areas were rated Good.
Improved safety arrangements
The home had made important changes since the previous inspection. Equipment was stored safely, the garden was fenced from the stream and risk assessments were in place.
“Measures had been taken to make the environment safer for people.” from the report
Kind and respectful care
Staff were friendly, attentive and reassuring. They respected people's dignity, preferences, languages and cultural needs.
“We observed staff were friendly and attentive to people” from the report
Personalised care and activities
Care plans described people's choices and support needs. The home had introduced a broader programme of activities since the previous inspection.
“There was a programme of varied activities including reminiscence.” from the report
Better management oversight
Records, audits and systems for tracking training, supervision and risk assessment reviews were stronger than before.
“We found that documents were better organised than during our previous visit” from the report
Pressure ulcer reporting
seriousSenior staff did not understand that grade three and four pressure ulcers must be reported as safeguarding concerns. The home reported these appropriately after the inspection.
“However we found that senior staff did not know it was their responsibility to report grade three and grade four pressure ulcers to the appropriate authorities.” from the report
Old DBS checks
needs fixingAll staff had DBS checks, but two checks dated from 2006 and 2008. Two staff files also lacked references until the home supplied copies after the inspection.
“Good practice would be to renew DBS checks every three years” from the report
Gap in fire alarm testing
needs fixingWeekly fire alarm testing had stopped for three weeks while the usual responsible person was absent. Managers agreed to make sure testing continued during absences.
“We noted there had been continuous weekly fire alarm testing from our last inspection until three weeks prior to our inspection when there was a gap.” from the report
Activities for people staying in bed
minorOne relative felt their relative did not have enough activities and could not use a call button when the bedroom door was closed. The home agreed to explore further options.
“There is no button to press if they need help and the door is closed.” from the report
- 01How are grade three and four pressure ulcers now identified and reported as safeguarding concerns?
- 02Have all DBS checks been renewed, and are references and other recruitment checks recorded on a checklist?
- 03How do you make sure weekly fire alarm testing continues when the usual staff member is absent?
- 04What activities and ways to call for help are available for people who remain in their bedrooms or stay in bed?
- 05How are verbal as well as written complaints recorded and reviewed?
This was an unannounced inspection of all five quality areas, following a previous inspection in December 2015 that found four breaches. This explanation was written from the published report of 5 May 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 Elmhurst Residential Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- November 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 December 2010.
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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At least 100 live-in carers within about an hour of Barnet
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 £1,300 a week. 83 can care for a couple. 12 years' experience on average.
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