Elizabeth Court

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met. The service was in breach of legal regulations in relation to person centred care. People or their relatives were not involved in the planning of how their care and support was provided. Outcomes for people were not always documented or reviewed

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The manager informed us they utilised communication cards and key rings however we did not observe these being used.

Sometimes, the care people received wasn’t as joined-up or responsive as it should have been. For example, care plans weren’t always updated when someone’s needs changed, which meant staff didn’t always have the right information to support them properly. Support was often only available at set times, which didn’t always fit around people’s daily lives or preferences. In some cases, important needs such as dietary requirements for people with diabetes, were not met. There were also times when decisions about someone’s care were made without involving other professionals who knew them well, which meant care wasn’t always well-coordinated or tailored to the individual.

The provider did not consistently offer appropriate, accurate, or current information in formats tailored to individuals' needs. There was no evidence that information was being delivered in accessible formats for people who required them. Staff had not received training on how to meet individuals’ communication needs, and care plans lacked guidance on supporting people who needed alternative communication methods. Where mental capacity assessments had been completed, there was no indication that information had been presented in a way that accommodated different communication needs. Additionally, there was limited evidence of effective information sharing between staff teams.

People told us they felt able to raise concerns when needed. One relative shared whilst they had not had to raise any concerns, they could speak to the staff if needed as they were, “All approachable.” While a complaints policy was in place, we found that complaints were not always investigated consistently, and outcomes were not routinely shared with those involved.

Feedback mechanisms, such as surveys, were used to gather views from both staff and relatives, offering opportunities for ongoing improvement. However, the effectiveness of follow-up actions varied. Not all relatives had been given the chance to share their views. One relative told us they had never been asked for feedback or invited to complete a survey. Another relative said they had completed a survey but had not seen any results shared.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Not all people living within Elizabeth Court had access to a dentist, we identified one person who required an appointment however this had not been sourced. Some people with complex needs were not provided with the same opportunities as those people who required less support, this included access to activities within the home and choice of care and support, particularly for those people who could not communicate verbally.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. We observed from people's care records that they were not supported to achieve meaningful outcomes. Whilst some generic goals were recorded for people for example, “to minimise risk of falling”, these were not monitored or maintained to ensure people's care was improving over time. We could not be assured that people were empowered by the provider to properly give their views.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Not everyone living within the service had end of life care plans in place, where they were in place, they lacked detail on how best to support that person when they were nearing the end of their life. There was not always evidence that discussions had taken place with the person being supported or their relative. Staff had received training in relation to end of life care.