CQC report explained · a residential care home
What the CQC found at Elworth Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Staffing, medicines, risk assessments, infection control and equipment safety were found to be managed well, although one liberty safeguard authorisation had briefly lapsed.
- Effective?
- Good
- This key question was not inspected during this visit. Its rating carried over from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating carried over from the previous inspection, although people and relatives gave positive comments about staff.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating carried over from the previous inspection.
- Well-led?
- Good
- Inspectors found effective quality systems and good knowledge of people's needs. However, management changes were not initially reported to CQC and communication training was incomplete.
What inspectors found, September 2023
Rated Good; inspectors found safe care and stronger management, but communication training and oversight of liberty safeguards need improvement.
The inspection was unannounced and took place on 19 June, 26 June and 31 July 2023. One inspector spoke with people living at the home, relatives and staff, and checked care, risk, medicines, recruitment and management records.
Inspectors found people generally felt safe and happy. Staffing levels met people's needs, medicines were recorded and stored safely, risks were reviewed, and the home was clean. A safeguarding concern had been referred to the local authority and was still being considered.
The home was rated Good overall, with Safe and Well-led both rated Good. Inspectors found improvements since the previous Requires Improvement rating, including enough progress to remove the previous breach of Regulation 17.
Safe staffing
Staffing levels met people's needs and staff were available to respond promptly. Recruitment systems were also found to be robust.
“Staffing levels met the needs of people.” from the report
Medicines management
Medicines were recorded after administration, stored safely and supported by clear protocols for medicines given when needed. This improved on the previous inspection.
“Improvements in the management of medicines had been made.” from the report
Risk management
Risk assessments were up to date and regularly reviewed. The home also monitored nutrition and hydration risks and maintained emergency evacuation plans.
“All risk assessments were up to date and were reviewed regularly.” from the report
Improved governance
The provider had made enough progress to address the previous governance breach. Quality assurance systems gave people, relatives and staff opportunities to share their views.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17.” from the report
Communication training
needs fixingOne person felt that some staff did not always take account of their communication style. Only 78% of staff had completed communication training, so inspectors recommended extending the training.
“We recommend that training in communication and person-centred care is extended to all relevant staff.” from the report
Liberty safeguards oversight
needs fixingOne person's Deprivation of Liberty Safeguards authorisation expired before a renewal application was completed. The manager acted quickly, but inspectors recommended stronger oversight.
“We recommend systems are put into place to ensure deprivation of liberty orders are reviewed appropriately.” from the report
Safeguarding matter under consideration
seriousA safeguarding concern was referred to the local authority during the inspection and had not yet been concluded when the report was written.
“This was referred to the local authority safeguarding team and is currently under consideration.” from the report
Management notification
minorThere had been several management changes. The provider did not initially tell CQC about the new arrangements and sent the notification retrospectively.
“The registered provider had not initially informed us of changes in management within the service.” from the report
- 01How have you extended communication and person-centred care training to all relevant staff?
- 02How do you check that each person's Deprivation of Liberty Safeguards authorisation is renewed before it expires?
- 03What is the current outcome of the safeguarding concern referred to the local authority?
- 04Who is currently managing the home, and has the manager's registration application been completed?
- 05How do you make sure staff understand and support each person's individual communication style?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 5 September 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, January 2022
Requires Improvement; inspectors found kind, person-centred care, but medicines records and quality checks were not always reliable.
This was the first inspection of the home. Inspectors visited on 4 and 25 November 2021, spoke with people, relatives and staff, observed care and medicines being given, and checked care, medicine, recruitment and management records.
People were described as safe and well cared for. Staff were kind, respectful and responsive. Care was tailored to people's needs, activities were available, and people praised the food and the support they received.
There were important gaps in medicines information and records. Some fire safety and staff recruitment records were also incomplete. The provider acted quickly during the inspection, but inspectors could not yet tell whether the improvements would last.
The overall rating was Requires Improvement. Effective, caring and responsive care were rated Good. Safe and well-led were rated Requires Improvement. The home must provide an action plan, and CQC will monitor progress and reinspect.
Kind and respectful care
Inspectors observed staff treating people with compassion, dignity and respect. People and relatives spoke positively about the care.
“Throughout this inspection we observed staff treating people with kindness, respect, promoting choice, seeking consent and offering sensitive emotional support when needed.” from the report
Personalised support
Care was planned around people's needs, preferences, hobbies and communication needs. People were supported to take part in activities and maintain relationships.
“Care plans were personalised and reflected the needs of the individual as well as their history, preferences choices, hobbies, and interest.” from the report
Food and mealtimes
People were offered varied and nutritious food. Inspectors saw a relaxed and sociable dining experience.
“We carried out the SOFI observation over a mealtime and could see that the dining experience was relaxed, pleasant and sociable.” from the report
Enough staff and staff support
Inspectors found enough staff to meet people's needs. Staff received training, induction and regular supervision.
“There were enough staff employed to meet the needs of the people who used the service.” from the report
Medicines records
seriousInformation for some medicines to be given when needed was missing or inaccurate. Some dates and allergy information were also wrong or contradictory.
“We found that written information to support the administration of 'when required medicines' was missing for four medicines and was inaccurate for two others.” from the report
Weak quality checks
seriousThe home's audits and governance systems did not identify the problems found with medicines, recruitment and fire safety records. This led to a breach of Regulation 17.
“We found no evidence that people had been harmed however, systems and records were not always robust enough to demonstrate risks to people's health were effectively monitored.” from the report
Fire safety records
needs fixingThe list for the fire service showed the wrong number of people, and the fire risk assessment did not mention all building materials. Both records were updated after inspectors raised the issues.
“On the second visit the "nominal role" which is a list of people in the home to be used in the event of a fire and handed to the fire service was not up to date” from the report
Recruitment checks
needs fixingOne new care worker had started personal care work before a reference and a related pre-employment check had been completed. This was corrected during the inspection.
“We noted that one reference had not been received and a related pre-employment check had not been completed, for a new member of the care team who had started work on personal care.” from the report
- 01What changes have been made to the information and protocols for medicines given when needed?
- 02How are medicine audits now checking for missing, inaccurate or contradictory information?
- 03How do you make sure every recruitment check and reference is complete before a new worker provides personal care?
- 04How often are the fire risk assessment and the list for the fire service checked and updated?
- 05What action plan was sent to CQC, and what evidence can you show that the improvements have been fully embedded?
This was the first comprehensive inspection, covering all five key questions and infection prevention and control measures; there were no earlier ratings to carry forward. This explanation was written from the published report of 13 January 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 Elworth Grange
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- September 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2020
Registered with the Care Quality Commission on 1 May 2020.
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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