Elizabeth House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. This overall key question rating is based on previous inspections, as we did not rate the full key question at this inspection. Improvements were made regarding monitoring people’s care when required, however further improvements were needed around people’s food choices.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We received some mixed feedback about the food in the service and people were not always effectively supported to make a choice about their meals. However, people had not lost weight. People’s fluid consumption was recorded when needed to ensure they had enough fluids to remain healthy.

One person spoke to us about their meals. They said, “It's alright. It's edible. You choose what you fancy at the time, it's alright. I can't knock it; it hasn't been horrible otherwise I wouldn't eat it." Another person said the food was ‘alright’. Another person described the food as ‘excellent’.

The provider had changed how they managed lunch time meals in the home. Hot main meals were delivered by an external company. These were ordered in advance and generally consisted of 2 options per day for people. We were told by the management team people enjoyed these meals and food was not left by people. The local authority also shared feedback that people were generally eating all of their meals. However, 1 staff member said, “Some residents have bigger appetites than others. I don’t think the meals we have delivered are sufficient for them. They ask for more. One person is in hospital, so we were able to split their spare meal between 2 other gentlemen.” We saw no evidence people had lost weight.

We observed there were not always effective measures being used by staff to enable people to make their own choices at lunch time. One person told us they never got to see a menu. People needed to choose their meal choice prior to lunch time and staff verbally asked people what they wanted from the main meal choices. However, some people struggled to decide when choices were offered to them in this manner. There was no visual representation of the food such as a photo and the meal was not shown to them at the mealtime so they could choose at that point. We also found that the provider only ordered 50% of each meal choice, if 1 of the options ran out, people had to have the second option or were offered other choices such as cheese on toast or soup as an alternative. The new registered manager told us the ordering of 50% of each meal choice had never been an issue. Following our feedback, the new registered manager agreed to create some visual aids to support staff to help people make their own choices.

People were not informed what the meal was when it was given to them at the dining table. Some people may have struggled to recall what they chose or recognise meals.

Staff told us people were able to ask for drinks whenever they wanted one. We also observed people being proactively offered a choice of drinks through the day as some people may not have been able to ask for a drink.

People had choices at breakfast and whilst people had the option to select main meals from a few options, we did not always observe choices being offered at all times. One person had finished eating their main meal. They were then given a warm pudding and left to eat it, but they were not offered the choice. The person later said they didn’t like it and were offered the alternative option, which they did want and ate. They could have been offered the choice in the first instance.

The lunchtime experience was calmer, more dignified and safer. Staff supported 1 person at a time and interacted with them in a person-centred way.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.