Elmcroft Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question inadequate. At this assessment the rating has remained inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes. The service was in continued breach of legal regulation in relation to safeguarding, as systems and processes were not established and operated effectively to prevent abuse or improper treatment.

This service scored 33 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. Whilst basic information was covered, there was no evidence to show how people had been involved in their own assessments and reviews or how their views and opinions were captured, respected, listened to and implemented as part of day-to-day support. We could not be assured people’s individual needs had been appropriately assessed and fully understood, or that the service could meet them. Assessments of need did not consider the full range of people’s diverse needs and physical health. Wellbeing and communication needs were not sufficiently assessed and planned for. Care records lacked detail on people’s strengths and the nature and level of support they needed to meet their needs and support their independence as much as possible.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People living at Elmcroft Care Home were at different stages of their dementia ranging from early onset to advanced stages. There was no plan about how the service kept up to date and develop positively in this area to ensure the care provided was right and reflected best practice. However, people’s nutrition and hydration needs were met. There was a new chef in post, who told us, “The manager likes to try the food I do. At the moment all good, I follow the meal plan but will add other things. I always make a cake for the afternoon tea. I also go around and speak to the residents about the food I cook and ask what they would like.” People confirmed this to be the case, and told us meals had improved. A staff member told us, “It’s old-fashioned food and [people] love it. The new chef puts cream in the porridge, and people’s weights are increasing.”

The service had made improvements to how they worked across teams and services to support people. However, as people’s assessments were not always comprehensive, up to date or accurate we could not be assured information shared with others would enable people to receive care in line with their needs. A professional who works with the service told us leaders had worked to address some of the issues which had occurred under previous management. The professional told us, “I have previously had difficulty with being able to see patients (people) during the day. I was told that I could only visit within a 2-hour window in the afternoon, otherwise the care home would be unable to accommodate my visits… Now when I visit nurses have taken time to speak with me and be present for initial assessments, enabling me to handover care appropriately.” The service worked with other professionals, including the GP, the hospice and dementia specialist services.

The service did not support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. The service did not support people to live healthier lives, or where possible, reduce their future needs for care and support. A person told us, “When I came here, I was supposed to have physio to help me walk, but this happened once and had no more. I do keep asking about walking but nothing happens. I would love to get out of bed. I don’t think they [staff] want me to.” We raised this as a concern with the local authority. A professional who works with the service told us, “The home have previously had issues with not being able to evidence when patients had completed their exercises. I requested for it be documented in their care plan; this was especially important when family of residents complained that they did not feel they were supporting with therapy. Despite my request I have not been shown documentation of exercise completion.” However, there was evidence to show improved health outcomes for some people living at the service as a result of the new manager’s experience and clinical background as a registered nurse.

The service did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent. Whilst people’s clinical treatment was monitored to check it was effective, such as catheter care and wound care, there was no effective monitoring of people’s wellbeing or quality of life outcomes. Daily records did not include information about how the person spent their day, their wellbeing, any monitoring or identified change in needs to inform a review or re-assessment of needs. The new manager was in the process of developing enhanced handover documents at the time of inspection to support with continued clinical oversight. However, this was not yet in place, and required more person-centred focus.

The service did not tell people about their rights around consent or respect these when delivering care and treatment. Consent and capacity were considered and recorded in care plans. However, this required some further input to ensure it was consistently clear. Staff knowledge was not consistently demonstrated in relation to mental capacity and Deprivation of Liberty Safeguards (DoLS), including how any conditions attached to DoLS were monitored. DoLS set out the legal authority for people to be deprived of their liberty, in their best interests. We raised a safeguarding referral for 1 person where a condition of their DoLS was for any objections to their placement to be recorded. There was no evidence staff were made aware of the need to record this information. The manager told us they would implement a new system to ensure staff awareness.