Elizabeth Court is a purpose built care facility that provides accommodation and personal care for up to 60 people. It is set over three floors and divided into five units. Each unit has its own dining area, small kitchen and lounge. The home supports older people, most of whom may be living with dementia or other conditions, such as Parkinson’s, as well as people who require daily support. On the day of our inspection 41 people were living in the home.
This inspection took place on 17 March 2015 and was unannounced.
The home is run by a registered manager, who was present on the day of the inspection. 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 and associated Regulations about how the service is run.
Where restrictions were in place, staff had not always followed legal requirements to make sure this was done in the person’s best interest. The registered manager had submitted some Deprivation of Liberty Safeguards (DoLS) applications to comply with their responsibilities, but they had yet to complete this piece of work. Processes in relation to the Mental Capacity Act (MCA) 2005 required improvement by staff .
We recognised the registered manager had undertaken a lot of work since they had started in the home. However, we found some areas required further work to enable us to say the home was consistently well-led. For example, we found care plans contained information to guide staff on how someone wished to be cared for. However, they did not always contain up to date information about people in relation to their care which meant staff may not be following the latest guidance .
People told us they felt safe and staff had access to written information about risks to people and how to manage these.
People were supported to take risks within a supportive environment and staff had carried out appropriate checks to make sure any risks of harm in the environment were identified and managed. For example, if people wished to smoke this had been assessed and protective equipment and procedures were in place to help keep people safe. Staff understood the need to use the correct type of sling for a person who required to be moved by a hoist in order to keep them free from harm.
Medicines were managed effectively and staff followed correct and appropriate procedures in relation to medicines. Medicines were stored in a safe way.
Staff knew how to recognise the signs of abuse and had received training in safeguarding adults. There was a copy of the Surrey multi-agency safeguarding procedures available to staff in the office and telephone numbers for people and staff on a noticeboard in the lobby.
Care was provided to people by staff who were competent to carry out their role effectively. The provider had taken steps to help ensure they employed staff appropriate for the role. Staff received regular training and supervision, although the registered manager told us staff appraisals were not up to date and this was a piece of on-going work.
We found enough staff on duty on the day of our inspection and did not see anyone waiting to be supported. We had feedback from some people and relatives that staffing levels had not always been consistent. The registered manager had worked hard to ensure they provided enough staff to enable people to receive care and support when they needed it.
It was evident staff had developed good relationships with people and knew them well. Staff were able to tell us individual information about people which told us they spoke with them and showed an interest in their past. Staff treated people with kindness and compassion and people were shown respect and allowed their privacy.
People were involved in their care and support and were encouraged by staff to do things for themselves, for example doing some washing up. People were provided with a choice of meals and facilities were available for people or staff to make drinks or snacks throughout the day.
Staff ensured people were referred to healthcare professionals to keep them healthy or when their health needs changed.
People were enabled to maintain their independence and take part in activities to reduce the risk of social isolation. During the day we heard staff speak to people in a kind, caring and encouraging manner. Staff took the time to work at people’s own pace and they never hurried or rushed people.
Complaint procedures were accessible to people and details were displayed on the noticeboard. We read the registered manager had responded to the complaints they had received.
Staff involved relatives in the running of the home by holding regular family meetings where everyone could express their views.
The registered manager was involved in the day to day running of the home and had a good understanding of the aims and objectives of the service. This was supported by our observations and staff comments. Staff said the registered manager checked they knew of and were following best practice.
We saw evidence of quality assurance checks carried out by the provider and staff to help ensure the environment was a safe place for people to live.
During the inspection we found some breaches 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.