CQC report explained · a nursing home
What the CQC found at New Elmcroft
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People did not always receive wound care or monitoring after falls in line with guidance and care plans. Some risk information and medicine records were also incomplete or inconsistent.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- Care was personalised and people were offered choices. The home supported activities, communication and contact with loved ones, including during COVID-19 restrictions.
- Well-led?
- Requires improvement
- Quality monitoring did not reliably identify shortfalls in care, communication or records. A new manager was making changes, but the systems were not yet embedded.
What inspectors found, May 2022
Rated Requires Improvement; inspectors found kind, responsive care but gaps in wound care, falls monitoring and quality checks.
This was a focused inspection carried out over 31 March and 4 April 2022. Inspectors spoke with people, relatives and staff, and checked care records, medicines, training and quality checks.
The home was rated Requires Improvement overall. Safe and well-led were also Requires Improvement. Inspectors found that wound care, monitoring after falls and some risk information were not always managed as planned. Records and quality checks did not always show that people had received the right care.
Responsive was rated Good. People were offered choices, their preferences were respected, and they had activities and support to keep in touch with relatives. A new manager had started making changes, but inspectors said these changes were not yet firmly established.
Personalised care
Staff knew people's preferences and supported them to make day-to-day choices. Care plans included personal histories, likes and dislikes.
“People received personalised care that was responsive to their needs.” from the report
Activities and relationships
People were offered group and one-to-one activities. The home helped people maintain contact with relatives during COVID-19 restrictions.
“People were supported to have contact with their loved ones throughout the COVID-19 pandemic and during the current outbreak.” from the report
Safeguarding awareness
Staff had safeguarding training and understood how to recognise and report possible abuse. Safeguarding investigations were carried out when needed.
“Staff had undertaken safeguarding training, knew how to recognise potential signs of abuse and understood their responsibilities.” from the report
Infection control
Inspectors were assured that staff used protective equipment safely and that the home had cleaning and infection control processes in place.
“We were assured that the provider was using PPE effectively and safely.” from the report
Supportive culture
People and relatives generally described staff as kind and respectful. Staff said the new manager had improved morale and was approachable.
“The managers and staff promoted a positive, person-centred culture which was evident throughout the inspection.” from the report
Wound care was not consistent
seriousSome people did not receive wound care in line with professional guidance and their care plans. Wounds were not always checked often enough, and records did not clearly show what care had been given.
“One person's wound was not adequately monitored for 10 days, another person for six days.” from the report
Falls monitoring
seriousPeople were not always monitored for changes in their health after a fall, including after a head injury. This could delay action if their condition worsened.
“People who experienced a fall were not always monitored for signs of deterioration to their health.” from the report
Registered manager not yet in post
needs fixingThere was no registered manager at the time of the inspection. A new manager had started the registration process and was providing management oversight.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01What checks now make sure wound care is provided and recorded exactly as set out in each person's care plan?
- 02How do you monitor people after a fall, and how quickly would relatives be told if there was a change in their health?
- 03Which risk information has been updated for my relative's health conditions, and how do staff find the current care plan?
- 04What evidence can you show that the new electronic records and quality checks are now being used consistently?
- 05Who is currently responsible for the home while the manager's registration process is completed?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 27 May 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.
What inspectors found, August 2018
New Elmcroft was rated Good overall, but inspectors found safety improvements were needed, including following advice about thickened drinks.
Inspectors visited the home without notice on 28 June 2018. They spoke with people, relatives, visitors, staff and healthcare professionals. They also reviewed care records, medicines records, staff files, incident reports and quality checks, and observed care.
The home was rated Good overall. Effective, caring, responsive and well-led care were rated Good. Safe care was rated Requires Improvement because some safety risks were not fully controlled and advice about thickened drinks had not always been followed.
People generally said they felt safe, cared for and listened to. Inspectors found kind, person-centred care, suitable activities, good healthcare support and positive management. The home had improved in effective care since the previous inspection, while safe care had deteriorated.
Kind and respectful care
People were supported in a sensitive way and their privacy, dignity, choices and relationships were respected.
“People were cared for in a kind and compassionate way.” from the report
Activities and social life
The home offered varied activities, entertainment, trips and ways for people to keep in touch with family and the local community.
“There was a fun, sociable and lively atmosphere.” from the report
Healthcare support
The home worked with healthcare professionals and made referrals when needed. Staff also used a joint monitoring initiative to identify possible deterioration in health.
“There was a coordinated approach to people's healthcare.” from the report
Responsive management
People and relatives said the management listened and acted on suggestions and concerns. Audits and staff discussions supported learning.
“There was an emphasis on continuous improvement and learning.” from the report
Unsafe access to some areas
seriousPeople had previously accessed areas including a boiler room, sluice room and fire escape. At the inspection, the sluice room door was still open despite having a keypad lock.
“There was a potential that a similar incident, to that which had previously occurred, could have occurred again if a person was to have entered the room.” from the report
Thickened drinks were not provided
seriousTwo people had been advised to have thickened drinks because of swallowing difficulties, but staff had not added the thickener. One person coughed while drinking and was not being directly observed at the time.
“Observations showed that thickener had not been added to either person's drinks.” from the report
Safety practice needed closer checking
needs fixingThe concerns were reported to staff and corrected immediately, but inspectors said this area of practice needed improvement.
“These incidents were immediately fed back to staff who ensured that both people's drinks were thickened in accordance with the guidance.” from the report
- 01How do you now check that doors to the boiler room, sluice room and fire escapes remain secure?
- 02How do you make sure advice from speech and language therapists, including thickened drinks, is followed for every person?
- 03How is staff practice checked when people are at risk of choking or need close observation while drinking?
- 04What changes were made after the safety concerns found at this inspection, and how have you checked that they are working?
- 05How do you monitor the improvements in safety since this inspection?
This was an unannounced inspection covering all five key questions; safe care was rated Requires Improvement, while the other four question ratings were Good. This explanation was written from the published report of 25 August 2018 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 New Elmcroft
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- May 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Goodstayed GoodSafe: Requires improvementResponsive: GoodWell-led: Good
- March 2016Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 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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