Elmsdene Care Home

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• 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

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 good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of the legal regulation in relation to safe care and treatment, and consent.

This service scored 50 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff assessed people’s needs and reviewed risks to people’s health and wellbeing regularly. People and relatives were involved in reviews of their care and support needs. Staff accessed people’s care plans via electronic handheld devices and information was updated in a timely manner. Staff recorded their daily care tasks on the same devices which managers reviewed to make sure care was being provided as per the care plan. Staff wrote care notes in a person-centred way.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We could not see a clear policy for what staff should do if someone had a fall, and some sets of observations were missing from a person’s records after they had experienced a fall. On 1 occasion we saw that staff did not complete a body map showing the site of the injury.

Staff recorded people’s weights and fluid intake; however, we noted some gaps in the recording of food intake. We were not assured whether action would be taken if people lost weight.

We did not see a wound care policy. There were people in the home who required wound care management, where best practice guidance regarding the recording of wounds had not been followed.

Under previous management, all bed rails had been removed as a ‘blanket approach’ following some incorrect advice. This had not yet been reviewed to look at whether people required bed rails or not. The new manager agreed to review this immediately.

We fed these concerns back to the provider, and they sent us relevant policies which would be communicated to staff. The changes made to the governance structure after the assessment also provided strengthened oversight.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

Although staff monitored and documented people’s health and wellbeing, governance systems required strengthening.

We saw that staff monitored people’s care and treatment, for example they recorded people’s weights and food and fluid intake. The service adopted a ‘resident of the day’ approach to thoroughly review all aspects of that person’s care and treatment. However, processes to monitor and oversee this needed to be embedded to make sure any issues were identified and changes made if required.

The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We did not see any Mental Capacity Act assessments or best interests’ decision-making documents completed by staff at the service, which meant we could not be assured correct processes were followed.

The service had an electronic monitoring system which recorded movement in people’s bedrooms and could also include the use of CCTV. This was to alert staff if someone had a fall. However, correct processes to obtain consent had not been followed.

The manager applied to the local authority to make sure legal processes were followed if someone was at risk of being deprived of their liberty. We saw copies of consent forms, for example consent to vaccinations in people’s care records.