CQC report explained · a residential care home
What the CQC found at Elmsdene Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, August 2023
Rated Inadequate and placed in special measures; inspectors found serious problems with medicines, risk management and people's rights.
This was an unannounced focused inspection. One inspector visited the home and spoke with staff and people living there. They reviewed care plans for seven people, medicines and accident records for everyone, and observed care and the home environment.
The home was rated Inadequate overall, and also Inadequate for Safe and Well-led. Inspectors found missing or inaccurate risk records, medicines were not always managed as prescribed, and staff did not always have the training needed to provide safe care.
Inspectors found blanket restrictions on people's choices. Bedroom doors were locked from the outside, and people were not allowed to eat or drink in their rooms without supervision. The provider removed the locks immediately and said assessments would be completed.
The home had safely recruited staff and was clean and tidy. People and staff inspectors spoke with said the home had improved and that people felt listened to. However, the provider remained in breach of regulations from the previous inspection, and the other three key question ratings were carried over because they were not inspected.
Safe recruitment
Inspectors found that staff were safely recruited, with appropriate checks and references.
“Staff were safely recruited. Appropriate DBS checks and references were collated after completion of full application and interviews to ensure suitable staff were employed.” from the report
Clean environment
The home was described as clean and tidy. Some infection-control issues were dealt with immediately when identified.
“There was enough available safely recruited staff to meet people's needs and the home was clean and tidy.” from the report
Kind interactions
Inspectors saw staff listen to people and heard laughter during their observations. People spoken with said they liked the staff and felt listened to.
“When we saw interactions between staff and people using the service, we saw staff listened to people and we heard laughter regularly.” from the report
Immediate response to restrictions
The provider removed the bedroom door locks during or shortly after the inspection and said it would assess people's needs and safety.
“The provider responded immediately during and after the inspection. Locks were immediately removed from the doors” from the report
Incomplete risk assessments
seriousRisks linked to bruises, wounds, reddened skin, falls and injuries were not always assessed or managed. Records were inconsistent, incomplete and sometimes inaccurate.
“People were not always safe from potential avoidable harm as a result of inappropriate or missing risk management.” from the report
Medicines not reliably managed
seriousSome people did not always receive medicines as prescribed. Some medicine records were inaccurate, and not all staff giving medicines had recent training or competency checks.
“People were not always receiving their medicines as prescribed, and records of prescriptions were not always reflected accurately on the Medicine Administration Records (MAR).” from the report
Staff lacked required skills
seriousStaff had not completed all the training needed for dementia, mental capacity, nutrition and hydration, medicines and emergencies. Night staff lacked first aid and medicines training.
“We found staff at all levels lacked the qualifications, competence, and skills to deliver good quality safe care to the people supported.” from the report
Restrictions without proper assessment
seriousBedroom doors were locked from outside without capacity assessments or best-interest decisions. People were also prevented from eating or drinking alone in their rooms without evidence of a choking risk assessment.
“There were no capacity assessments in place to show people had been asked if they wanted their door locked in this way.” from the report
Weak oversight
seriousAudits and monitoring covered only limited records and did not identify problems found by inspectors. Governance systems were still at an early stage.
“There was not an effective system of quality assurance or audit. Governance procedures were in their infancy or not developed.” from the report
- 01What risk assessments and care plans have now been completed for bruises, wounds, falls and unwitnessed injuries?
- 02How do you check that medicines are given as prescribed and that medicine records are accurate?
- 03Have all staff, including night staff, completed the required training and competency checks for medicines, first aid, dementia, mental capacity, nutrition and hydration?
- 04What capacity assessments and best-interest decisions are now in place for bedroom doors and eating or drinking in bedrooms?
- 05How will the new care-planning system and audits identify problems across all residents' records, rather than only a small sample?
This was an unannounced focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried over from the previous inspection. This explanation was written from the published report of 11 August 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, October 2020
Rated Requires Improvement; inspectors found risks in staffing, records and quality checks.
This was a targeted inspection after concerns about staffing and risk management. Inspectors widened it to a focused inspection covering Safe and Well-led. They spoke with people, a relative, staff and other professionals, observed care, and checked care, medicine, staff and management records.
The home did not always have enough suitably trained staff. Some risks to people were not recorded clearly, and some care records were incomplete or out of date. Cleaning and maintenance also needed improvement, although the home had enough personal protective equipment.
The home had caring staff and a positive culture. Inspectors found that managers were open to feedback and acted quickly during and after the inspection. However, quality checks and records were not reliable enough to show that care was consistently safe and well managed.
The overall rating changed from Good at the previous inspection to Requires Improvement. The home must provide an action plan, and the CQC said it would monitor progress and inspect again.
Positive staff culture
Inspectors found a positive culture, and staff said they felt supported and valued by managers.
“There was a positive staff culture at the service and staff told us they enjoyed their jobs.” from the report
Caring relationships
Inspectors saw that people were comfortable with managers and staff. Relatives also gave positive feedback about the care and communication.
“Good relationships had been developed between management, staff and people using the service and their family members.” from the report
Person-centred medicines support
Staff gave people time to take medicines calmly and patiently. The report also says staff who administered medicines had completed appropriate training.
“Medicines administration was person-centred. People were given time to take their medicines in a calm and patient manner.” from the report
Open response to feedback
The management team accepted the inspectors' concerns and responded immediately during and after the inspection.
“Additionally, they responded immediately to our concerns during and after the inspection.” from the report
Working with professionals
The home worked with health and social care professionals to support people's needs.
“Records and discussion showed the service worked in partnership with a variety of health and social care professionals to ensure people received the support they needed.” from the report
Staffing and training
seriousThe home could not show that staffing numbers and skills were based on people's needs. Staff had not received training in several important areas, including first aid, dementia care, equality and swallowing difficulties.
“There was no systematic approach to determine the numbers and skill mix of staff needed to meet people's needs.” from the report
Incomplete risk and care records
seriousRisks were not always recorded, and care plans did not consistently explain how staff should keep people safe. Inspectors found inconsistencies in five people's care plans.
“We found inconsistencies in five peoples care plans.” from the report
Weak quality checks
seriousAudits and other checks were not systematic or consistently documented. Some problems had not been identified by the management team.
“We found no systematic approach to audits and many of the checks staff told us they completed were not documented.” from the report
Cleanliness and infection control
needs fixingSeveral areas were unclean, some items were exposed in bathrooms, and chipped paintwork affected high-traffic areas. Cleaning checks had not identified all the problems.
“During the inspection, we found the environment was unclean in several areas.” from the report
Medicine check records
minorManagers carried out monthly medicine checks, but some checks were not documented, including checks involving medicines given when needed.
“However, we found checks were not always documented. An example of this was for as and when required medications.” from the report
- 01How do you now calculate the number and mix of staff needed for each shift, including night shifts?
- 02Which staff have completed training in first aid, dementia care, equality, swallowing difficulties and safeguarding?
- 03How are risks and care plans checked so they are complete, accurate and kept up to date?
- 04What changes have you made to cleaning, infection control and the recording of cleaning checks?
- 05What actions from the Regulation 17 and Regulation 18 action plan have been completed, and how are you checking that they work?
This was a focused inspection of Safe and Well-led after concerns about staffing and risk management; Effective, Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 15 October 2020 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 Elmsdene Care Home
4 rated inspections over 7 years: the service has slipped, from Good to Inadequate.
- August 2023Inadequatecurrent ratingdown from Requires improvementSafe: InadequateEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- October 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2018Goodstayed GoodSafe: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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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32 live-in carers within about an hour of Blackpool
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 £1,250 a week. 31 can care for a couple. 12 years' experience on average.
“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.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.