This inspection took place on 28 June and 8 July 2016. The first day of the inspection was unannounced. The second day of the inspection was announced, as we wanted to ensure the manager and provider were present.Elmfield House is registered to provide accommodation with personal care for up to 18 people. At the time of our inspection there were 18 people living at the service, some of whom were living with dementia.
At the time of our visit there was no registered manager in post. There had not been a registered manager in post at the service since October 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People and their relatives told us they felt the service was safe. People told us that staff were very kind and they had not experienced any issues to their safety whilst living at the service. Staff had received training in relation to safeguarding and they were able to describe the types of abuse and the processes to be followed when reporting suspected or actual abuse.
Staff had received training, regular supervisions and annual appraisals that helped them to perform their duties. New staff received a full induction to the service which included training.
There were enough staff to ensure that people’s assessed needs could be met.
Where there were restrictions in place, staff had followed the legal requirements to make sure this was done in the person’s best interests. Staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way.
People and relatives were positive about the care provided and their consent was sought.
People’s care and health needs were assessed and they were able to access all healthcare professionals as and when they required.
People’s nutritional needs had been assessed and people were supported to eat and drink as and when required. The menus provided a choice of meals and people were able to choose a meal that was different to the menu choices.
Documentation that enabled staff to support people and to record the care they had received was up to date and regularly reviewed. People and/or their relatives had signed their care plans to signify their involvement in their care. People’s preferences, likes and dislikes were recorded and staff were knowledgeable about the care needs of people.
Staff showed kindness and compassion and people’s privacy and dignity were upheld. People were able to spend time on their own in their bedrooms and their personal care needs were attended to in private. People we spoke to consistently said that they liked the service.
People were able to take part in meaningful activities that helped to prevent them from becoming isolated.
People and relatives told us they thought the service was well run and they were able to have open discussions with staff. People told us they were able to raise concerns and make complaints if they needed to.
Staff were knowledgeable about the values and visions of the service and worked in line with these. Staff were also aware of the whistle-blowing procedures and would not hesitate to report bad practice.
Quality assurance processes were in place to help drive improvement at the service.
At our last inspection in July 2014 we found the provider was in breach of the Health and Social Care Act 2008 that related to staff recruitment. At this inspection we found the provider had taken action to comply with the relevant regulation.
During this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.