CQC report explained · a nursing home
What the CQC found at Eltisley Manor
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about infection prevention and control. This included testing, use of personal protective equipment, cleaning, visiting arrangements and plans to prevent or manage outbreaks.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, April 2021
Eltisley Manor was inspected but not rated; inspectors were assured that infection control and visiting arrangements were in place.
This was an announced, targeted inspection on 8 April 2021. It checked how well the home was prepared to prevent and control infections during the COVID-19 pandemic. Inspectors visited the home and reviewed infection control policies and audit findings.
Inspectors were assured that the home had an up-to-date infection control policy, was arranging testing, and was following shielding and social distancing rules. They were also assured that the home was using personal protective equipment safely and managing possible outbreaks.
The home was clean, with cleaning taking place during the visit. Visitors were tested, screened, had their temperature checked and were given personal protective equipment. The service was inspected but not rated, so this report does not give an overall quality rating.
Infection control policy
The home had an up-to-date infection prevention and control policy, with procedures and risk assessments for COVID-19.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Visitor safety
Visitors were screened and tested before entering, and were given personal protective equipment.
“Visitors undertook a rapid COVID -19 test before entry to the building.” from the report
Keeping people in contact
People could keep in touch with friends and relatives through video calls and telephone calls, with staff help when needed.
“People were able to stay in contact with friends and relatives via facetime and zoom as well as via the telephone.” from the report
Clean premises
Inspectors found the service clean, with cleaning taking place during their visit.
“The service was clean and there was cleaning in progress throughout our visit.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now?
- 02How are visitors currently tested, screened and supported to use personal protective equipment?
- 03How does the home prevent and manage infection outbreaks?
- 04How can residents currently keep in touch with relatives, including when visits are restricted?
- 05When was the home's infection control policy last reviewed?
This was a targeted inspection of infection prevention and control during the COVID-19 pandemic; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 29 April 2021 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, March 2019
Eltisley Manor was rated Good; inspectors found safe, kind and personalised care, with activities provision the main area to check.
Inspectors carried out an unannounced visit on 27 November 2018 and considered further information received on 18 December 2018. They observed care, spoke with seven people and 12 staff, checked four care records and reviewed other records such as rotas, meeting minutes and audits.
The home provided nursing and personal care for 37 adults and older people with mental health needs. Inspectors found enough suitable staff, safe medicines practice, personalised care plans and good support for people's health, independence and daily choices.
People said they felt safe and were treated with kindness, dignity and respect. The home offered work, education, volunteering and other activities, although there was no activities coordinator when inspectors visited and a local authority review had recently said there were not enough activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as the previous inspection, published on 10 June 2016.
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment checks were completed before new staff started.
“There were enough suitable staff deployed to ensure they could meet people's needs and keep people as safe as possible.” from the report
Personalised care
Care plans explained people's goals, choices and risks. People were involved in planning and reviewing their support.
“Each person had a fully personalised support plan, which showed that, if they were able to, the person had signed to agree they had been involved in planning their care and support.” from the report
Kind and respectful staff
People described staff positively. Inspectors saw respectful relationships and support that protected privacy and dignity.
“A team of staff who were kind, compassionate and professional cared for and supported people who lived at Eltisley Manor.” from the report
Support for independence
People were supported to manage medicines, cook, make drinks, work and learn everyday living skills. The Coach House helped some people prepare for more independent living.
“Staff encouraged people to be as independent as they could be.” from the report
Strong leadership and checks
The management team supported staff and used audits, meetings and feedback to monitor the home and make improvements.
“The registered manager and deputy manager provided strong leadership to a competent and knowledgeable staff team who worked hard to give people high quality care and support.” from the report
Activities staffing
needs fixingThere was no activities coordinator when inspectors visited. A local authority safeguarding review the previous week had said there were not enough activities, although the manager described other opportunities available.
“At the time of the inspection there was no activities coordinator employed.” from the report
Use of agency staff
minorThe home used some agency staff because permanent staff were difficult to recruit. Inspectors said these staff were inducted and trained, but families may want to check how this affects continuity.
“Due to the difficulty in recruiting permanent staff, the registered manager employed some agency staff.” from the report
- 01Who now organises activities, and how many activities are available each week for people with different interests and abilities?
- 02How often are agency staff used, and how are they introduced to each person's care plan and needs?
- 03How does the home support people in the Coach House to move towards more independent living?
- 04How are people assessed and supported if they want to take responsibility for their own medicines?
- 05How often are people's goals and support plans reviewed with them and, where wanted, their relatives?
This was a planned, unannounced inspection covering all five CQC questions, and the report says CQC looked at both the care provided and the premises. This explanation was written from the published report of 8 March 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 Eltisley Manor
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- March 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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17 live-in carers within about an hour of Cambridgeshire
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 £1,200 a week. 14 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.