Elizabeth House

Updated 1 December 2021

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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Elizabeth House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. However, the application for registered manager had been submitted and was in progress. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority safeguarding and service improvement teams. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and six relatives about their experience of the care provided. We spoke with 16 members of staff including the manager, regional operations manager, administrator, care team leader, care workers and the chef. We made general observations throughout the day of the interactions between people and staff.

We reviewed a range of records. This included five people’s care records and three medication records. We looked at three 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 reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from three health and social care professionals who regularly visit the service.

Updated 1 December 2021

About the service

Elizabeth House is a purpose-built residential care home providing personal and accommodation for up to 43 older people. They were providing care and support to 38 people at the time of inspection.

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

Improvements had been made to the processes for the understanding and recording of consent. There were clear, embedded practices in place. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were enough staff on duty. However, we did receive some mixed feedback about staffing levels. Changes to the mandatory requirements of vaccinations for care workers in England had proved to be challenging for the home. The manager and regional operations manager told us they would keep this under continual review.

People, their relatives and staff told us Elizabeth House was a safe place to be. People’s care and support were helped by robust risk assessments which enabled them to live their life the in a safe way. Staff had a good understanding of safeguarding and there were clear reporting procedures both within the home and outside. The home had made all necessary referrals to ensure people were protected from harm.

Medicines were managed safely, and environmental checks ensured people could enjoy their surroundings and be safe and comfortable. Lessons were learned and there was a continual improvement plan in place. People were supported by staff who were recruited safely and well trained. Staff had the opportunity to discuss their work within formal supervisions and felt they could request support at any time.

People were offered the foods and drinks they enjoyed. Access to healthcare was available and input was regular. Health and social care professionals who worked with the service were complimentary. Specialist and routine healthcare appointments were sought in a timely manner.

Quality assurance systems operated effectively within the home. Audits monitored all aspects of the care, support and home’s operation. The manager was supported by an established team, well thought of by all and seen as approachable and reliable. Staff felt proud to work at Elizabeth House and told us they were one big family, putting people at the centre of all they did.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 September 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 9 July 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve need for consent.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elizabeth House on our website at www.cqc.org.uk.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.