St Elizabeth's Health Agency

Updated 15 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was completed by an inspector, two medicine inspectors and a specialist professional advisor.

Service and service type

St Elizabeth's Health Agency provides intensive epilepsy, health and therapeutic support to children using the centre’s services with epilepsy. Nurse led clinics are also run for younger people who use the school, college and home on site.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 young person who used the service, 4 external care staff who support the children and young people, and we spoke with 4 health professionals. Where people were unable to communicate, we spent time in the clinical area to see how the young people were treated by staff. We spoke with 5 members of staff including the registered manager, senior nurses, human resources and nurses. We reviewed 4 people's care records and 6 medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 15 February 2023

About the service

St Elizabeth's Health Agency provides intensive epilepsy, health and therapeutic support to children and young people with a learning disability using the centre’s services. Nurse led clinics are also run for younger people who use the school, college and the children's care home on site. St Elizabeth’s Health Agency provide nursing care to 22 children and young people at the time of the inspection.

People’s experience of using this service and what we found

Right support

Children and young people were safe and protected from potential abuse because the staff knew how to identify and report any concerns relating to the risk of abuse. Risks to their health, safety and well-being were assessed, and measures were put in place to remove or reduce the risks. Children and young people were supported by nurses who had been safely recruited.

Nurses supported children and young people to make decisions about their health and wellbeing by following the correct legislation. Nurses communicated with the children and young people in ways that met their needs. for example, using social stories. Nurses supported children and young people to play an active role in maintaining their own health and wellbeing

Right care

Children and young people had a robust assessment to help ensure their needs and preferences could be met. Care plans were developed from these assessments for each identified need.

Nurses protected and respected children and young people’s privacy and dignity. They understood and responded to their individual health needs.

The nurses knew the young people and children well and were able to promptly identify when their needs changed, supporting them to get the right medical help they needed.

Right culture

The provider needed to develop a robust governance system to ensure that the nurses were working in line with best practice and that there was enough skilled managerial oversight of the service. The registered manager did not have clinical direction from the provider and quality checks were not being made by the provider. This was something the registered manager was starting to develop with the provider.

External professionals and care workers said the nurses and the management team were always available and supportive.

The management team was committed to providing good quality nursing care to the children and young people they supported, (as well as the support to their care workers, ) and understood their responsibilities under the Duty of Candour to be open and honest with the everyone they supported.

Risk assessments were in place in most cases, which identified risks children and young people faced and how nurses should manage these. There were further developments required where not all health needs were identified in the risk assessment; however, nurses were aware of these health conditions.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 10 October 2020 and this is the first inspection. We conducted a targeted inspection published 03 August 2022, however, we did not rate the service at that inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified a recommendation that the provider reviews the internal clinical oversight for the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.