CQC report explained · a residential care home
What the CQC found at Elmwood Residential Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Elmwood Residential Home Limited rated Requires Improvement; inspectors found safety, training, consent and management problems, although people generally felt safe and well cared for.
This was an unannounced focused inspection on 6 and 13 December 2022. Two inspectors and an Expert by Experience spoke with people, relatives, staff and health professionals. They observed care and checked care, medicine, training, recruitment, incident and management records.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were also rated Requires Improvement. Inspectors found problems with risk assessments, fire safety, medicines, staffing levels, staff training and legal consent arrangements. Some risks were dealt with during or after the inspection.
People and relatives generally said they felt safe. Inspectors found that staff knew people well, worked with health professionals and supported access to the garden. Infection prevention arrangements were assessed positively.
The previous overall rating was Good, published in November 2018. This focused inspection reviewed Safe, Effective and Well-led because of concerns about management and feedback from health professionals. The Caring and Responsive areas were not inspected during this visit.
People generally felt safe
People and relatives told inspectors that they felt secure and had no complaints about their safety.
“People and relatives felt the service was safe.” from the report
Infection prevention
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including the use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Health professional links
Staff worked with GPs, community nurses and other professionals to support people's health needs.
“Staff worked well with health and social care professionals to ensure people received appropriate care in a timely way.” from the report
Recruitment checks
The provider carried out checks such as references and DBS checks before employing staff.
“The provider carried out recruitment checks to ensure staff were suitable to work at the service.” from the report
Risks were not always reviewed
seriousRisk assessments for skin damage and malnutrition were not always updated when people's needs changed. Fire doors, a window and shower temperatures also created safety risks until action was taken.
“Risk assessment screening tools for malnutrition were not being reviewed regularly to identify individual risks.” from the report
Medicine safety
needs fixingMedicine records were sometimes inaccurate, patch locations were not always recorded and fridge temperatures were recorded below freezing without prompt action. Inspectors recommended checking that staff were competent to give medicines safely.
“Medicines stored in the medicine fridge were at risk of not being safely stored.” from the report
Staffing and training
seriousThere were only two night staff supporting 34 people, although nine people needed two staff for some care tasks. Some staff also lacked refresher training or recent competency checks.
“There were not always enough staff on duty to support people safely.” from the report
Consent and restrictions
seriousSome people had restrictions without the required legal authorisation, and staff could not explain who had a DoLS in place or what conditions applied.
“We identified people at the home without a DoLS in place that were having restrictions placed upon them without the legal authorisation to do so.” from the report
Management oversight
seriousAfter the registered manager left, important checks on risks, falls, incidents, medicines and consent fell behind. This meant the provider did not identify or address problems quickly enough.
“Since the registered manager had left in October 2022 managerial oversight had fallen behind at the home.” from the report
- 01Have all individual risk assessments for skin integrity, malnutrition and falls been reviewed and kept up to date?
- 02How are medicines fridge temperatures, controlled medicines and transdermal patch locations now checked?
- 03How many staff are on duty at night, and how is this number matched to people's current care needs?
- 04Which staff have had their medicine competency and refresher training completed?
- 05Which people have DoLS applications or authorisations, and how are best-interest decisions and any conditions recorded?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the report says ratings for uninspected areas were carried over from the last inspection. This explanation was written from the published report of 28 January 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, February 2022
Elmwood Residential Home Limited was inspected but not rated; inspectors found strong infection control and visiting arrangements.
This was an unannounced, targeted inspection on 9 February 2022. Inspectors looked mainly at infection prevention and control, visiting arrangements and whether COVID-19 staffing pressures affected care.
Inspectors found the home clean and free from odours. There were regular cleaning schedules, testing for people, staff and visitors, checks before entry, enough protective equipment and an up-to-date infection control policy.
Relatives and friends were able to visit. Two garden-access rooms had been adapted with screens, seating, protective equipment, handwashing facilities and intercoms.
The service was inspected but not rated. This means the report gives findings about the areas checked, but it does not give an overall quality rating.
Clean environment
The home was clean, had no unpleasant smells and used cleaning schedules and frequent cleaning of commonly touched surfaces.
“The home was clean and free from odours.” from the report
Infection control
There was regular COVID-19 testing, screening before entry, enough protective equipment and a regularly updated infection control policy.
“The provider had a regular programme of COVID-19 testing for people in the home, staff, and visitors.” from the report
Family visiting
Visits were supported and the home created two garden-access rooms to make visits safer and easier during changing COVID-19 guidance.
“Visits with relatives and friends were accommodated and adaptations made in response to the changing government guidelines.” from the report
Staffing pressures managed
Inspectors found that COVID-19-related workforce pressures were not having a harmful effect on care delivery.
“Workforce pressures were not having a detrimental impact on the delivery of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently test people living here, staff and visitors for COVID-19?
- 02What checks are now required before relatives and professionals enter the home?
- 03Are the two garden-access visiting rooms still available, and how are visits arranged?
- 04How do you make sure there is enough protective equipment for people, staff and visitors?
- 05How would you protect my relative if they needed to go into hospital?
This was an unannounced targeted inspection of infection prevention and control, visiting arrangements and COVID-19 staffing pressures; the service was inspected but not rated. This explanation was written from the published report of 26 February 2022 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 Elmwood Residential Home Limited
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Elmwood Residential Home Limited →
- February 2022Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at Elmwood Residential Home Limited →
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Requires improvementstayed Requires improvementSafe: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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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17 live-in carers within about an hour of Devon
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 £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
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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.