Archived: Elizabeth Homes

We found the following examples of good practice.

Staff followed government guidance in relation to personal protective equipment (PPE) and infection prevention and control (IPC) practices. The service had an ample supply of PPE and stock levels were monitored by the registered manager and the IPC leads.

COVID-19 testing was taking place for all staff and some of the people who used the service. Where people lacked capacity to consent to testing, a Mental Capacity assessment and Best Interests meeting had been carried out. Staff monitored people for signs and symptoms of COVID-19, and appropriate processes were in place and followed should anyone display any symptoms of COVID-19.

Staff supported people’s social and emotional wellbeing. The provider and staff kept family members up to date about the latest guidance and their relative’s health via regular telephone calls, letters and emails.

Audits were in place and used to ensure the service was providing safe care and staff were following guidance.

All staff had undertaken training in IPC. This included putting on and taking off PPE, hand hygiene and other COVID-19 training.

The inspection took place on 19 and 24 April 2018 and was unannounced.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff had received appropriate training to ensure people were protected from avoidable harm and abuse. Systems and processes were maintained to record, evaluate and action any outcomes where safeguarding concerns had been raised.

Assessments of risks associated with people’s care and support and for their environment had been completed. Support plans provided information for staff and other health professionals to ensure people received safe care and support without undue restrictions in place.

The provider maintained safe staffing levels to meet people’s needs. Staff recruitment included pre-employment checks that helped to ensure only suitable employees were recruited to work in the home.

Systems and processes ensured safe management of medicines and infection control.

People received appropriate care and support to meet their individual needs, because staff were supported to have the skills, knowledge and supervision they needed to carry out their roles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The provider was committed to providing people with a positive caring partnership with staff who were clear about the importance of paying attention to people’s wellbeing, privacy, dignity and independence.

The provider equipped staff with the skills and knowledge to appreciate and respond to the principles of equality and diversity. The provider ensured everybody received care and support that reflected their wishes and preferences and this information was recorded.

People continued to be involved in shaping their care and support. Records were evaluated for their effectiveness and amended to ensure they were up-to-date and reflective of the person’s current needs. Support plans continued to be person-centred.

Staff supported people to live as they choose and to enjoy a variety of meaningful activities.

Systems and processes were in place to support people should they need to raise a complaint.

People, their relatives, staff and other health professionals were consulted and their views and feedback used to help shape the service and maintain high standards of care and support.

The quality assurance system remained effective. Oversight by the registered manager ensured outcomes were evaluated for their effectiveness with timely action implemented where improvements were required.

Further information is in the detailed findings below.

We saw improvements had been made to the cleanliness of the general environment and the living areas within the service. The provider had invested time and money into supplying new furniture, furnishings and floor coverings for a number of areas within the home and developed new cleaning schedules to sustain the improvements. People said 'The home is looking lovely now and everywhere looks clean and fresh.'

The provider had recruited additional domestic and care staff since our last inspection in July 2013. Staff told us 'We have more time to do our own jobs now.'

We found systems to monitor and evaluate the quality of the care were in place and being used appropriately. People told us they knew who to talk to if they had any concerns and were confident that the acting manager would deal with them quickly.

Our observations of the service showed us that the staff were very kind and caring and all the people who spoke with us were very happy with their care. One person said 'The staff are very good, they listen to what we say', another person said 'The staff look after us well, they do their best to answer the call bells quickly and nothing is too much trouble.' However, we found that the quality of the care people received varied.

People said they were happy with their rooms and the communal areas. However, we had a number of concerns about infection prevention and control, the environment and fire safety practices within the service. These have been discussed within the report.

We looked at staffing levels as part of our visit and we found there were insufficient numbers of suitably qualified, skilled and experienced staff. Two people told us 'The care staff are very good, friendly and supportive but they are always rushing around and do not have time to sit with people and chat.'

We found that improvements were needed to the quality assurance system to ensure people's health, safety and care was monitored effectively and that appropriate action could be taken where necessary to make changes in the service.

We found that the provider and staff had acted on the information in the report from October 2012 and made positive changes to medication practices, staff training, staff supervisions and record keeping within the service.

People who used the service were satisfied with the care they received and said that they did not have to wait too long for staff when they needed assistance. Individuals told us 'Staff are friendly, helpful and supportive.'

People we spoke with were confident about using the complaints system in place and satisfied that staff or the manager would take action to solve their problems.

Our observations of the service showed that staff spoke with and interacted with people who used the service in a patient and pleasant manner.

We found that medication recording and administration within the service did not always follow the policies and procedures of the service and presented some risk to people who used the service. Report writing in the care records was poor and did not always reflect the changes in care and treatment that people received. We also found that staff did not receive sufficient support and monitoring of their working practice through regular supervisions.