Elizabeth House

Updated 19 January 2024

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

The inspection was carried out by 2 inspectors 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 and personal care as a single package under one contractual agreement dependent on their registration with us. Elizabeth House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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 the 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 3 people living in the home and 7 relatives about their experience of the care provided. We spoke with 11 members of staff including care workers, senior staff, deputy manager, registered manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 5 people's care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed, including policies and procedures and health and safety documents.

Updated 19 January 2024

About the service

Elizabeth House is a residential care home providing personal care to up to 35 people. The service provides support to older people and people living with dementia in 1 adapted building. At the time of our inspection there were 20 people living in the home.

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

Infection prevention control measures, maintenance of the environment and storage of equipment were not effectively managed or maintained to ensure people lived in a safe environment. Governance and quality monitoring processes were not effective when monitoring the environment and risk management. The registered manager was registered with another care home under a different provider. We raised concerns this may impact on their time and ability to oversee both services effectively.

People spoke positively about the care they received, and relatives told us their family members were safe. Staff knew how to keep people safe and protect them from harm. People received their medicines safely, when needed, by staff trained in medicine management. Staff were recruited safely.

Staff told us they felt supported by the registered manager and attended regular meetings. The provider and staff worked in partnership with other health and social care agencies to promote people's health and well-being.

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.

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

Rating at last inspection

The last rating for this service was good (published 17 September 2022).

Why we inspected

The inspection was prompted in part due to concerns received about staff bringing their children into the home and leaving them unsupervised and we received concerns over staff recruitment. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. Whilst we did not find any concerns relating to children and recruitment, we did raise concerns over the general environment, infection prevention control practices and quality control monitoring.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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.

Enforcement

We have identified breaches in relation to the maintenance of the environment, infection prevention control and storage of equipment and to the overall governance of the service at this inspection.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.