Elizabeth House

We found the following examples of good practice.

¿ People were offered constant reassurance and information about the pandemic to ease any anxieties and help them understand the measures in place. People’s health conditions could impact their short term memory and staff took this into account when providing support.

¿ Staff had received training in the use of personal protective equipment (PPE) and used it in line with guidance. Some people chose to wear masks and they had access to a supply of masks for their use.

¿ The registered manager monitored the guidance issued and updated policies and procedures in line with any changes. Staff were made aware of changes via meetings and email alerts.

Elizabeth House is a residential care home providing personal care to 22 people most of who are living with Korsakov’s syndrome and had a history of alcohol dependence.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection eight people were in receipt of personal care.

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

People told us they felt safe and happy living at Elizabeth House. People were supported to take positive risks which included being out in the community without support from staff. People told us there were enough staff to support them and meet their needs. People were involved in the recruitment of potential new staff, by meeting with them and being involved in making decisions about successful applicants. People received support with their medicines in their preferred way.

Before people moved into the service, managers completed an assessment of their needs to ensure that staff could meet these. When people’s needs changed, staff worked with healthcare professionals to review the person, and followed any guidelines implemented. People were supported by staff who had received training and support to enable them to provide effective care.

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.

We observed kind and caring interactions during our inspection. Staff knew people well and were able to meet their needs. People were supported to make decisions about their care and treatment. Staff treated people with dignity and respect.

Healthcare professionals who had visited the service told us they found staff to be person centred and treat people as individuals. People had person centred care plans, some people made their own entries in their care plans. People were supported to take part in a range of activities.

When people had concerns or complaints managers ensured they were responded to and resolved in line with the providers policy.

We observed a positive culture, focused on achieving good outcomes for people. Managers were open and transparent, and people and staff felt they were able to approach them at any time. Managers and staff were working with healthcare professionals to increase knowledge about Korsakoff’s.

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 15 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Elizabeth House is registered to provide accommodation and personal care for up to 22 people. Most people were living with Korsakov’s syndrome and had a history of alcohol dependence. Korsakov’s syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). People required support with processing and retaining information and the service supported them to be as independent as possible.

The service is situated close to another care home service run by the same provider and shares staff and management with the other service. The provider had recently renovated a house adjacent to Elizabeth House, containing six additional bedrooms and people were due to be moving in shortly. Downstairs there was a kitchen, dining room and lounge. Each person had their own bedroom and there were multiple bathrooms throughout the service.

The service had a registered manager in post. A registered manager is a person who is 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 2008 and associated Regulations, about how the service is run.

The management team had identified that some training and regular one to one meetings where staff could reflect on their practice were overdue. Staff were directed to physically intervene in extreme circumstances, but had not received the training to do so safely. There was a plan in place to rectify this, but it had not yet been completed; so this was an area for improvement.

Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. However, the paperwork relating to this could not be immediately located. The gas certificate for the service was out of date and the registered manager booked someone to come and check it was safe immediately. Regular fire drills were completed.

People were actively involved in writing their support plans and risk assessments. They identified goals to work towards and these were consistently met. An in-house cognitive behavioural therapist worked with people to help them understand their condition and how it impacted on their lives. People took part in a variety of activities inside and outside of the service. Some people lead their own activities, and on the morning of the inspection a current affairs session took place. Complaints were investigated and responded to promptly.

Staff knew how to recognise and respond to abuse. The registered manager was aware of their responsibilities regarding safeguarding and staff were confident the registered manager would act if any concerns were reported to them.

There was enough staff to keep people safe. Staff were checked before they started working with people to ensure they were of good character and had the necessary skills and experience to support people effectively.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant local authority, in line with guidance.

People were supported to eat and drink a range of healthy and nutritious food. Food appeared home cooked and appetising.

Risks relating to people’s health and mobility had been assessed and minimised where possible. People received their medicines when they needed them. Staff had sought advice and guidance from a variety of healthcare professionals to ensure people received the best care possible. Staff followed guidance and advice given by health care professionals.

People told us that staff were kind and caring. Staff knew people well and people were supported to be as independent as possible. People were treated with dignity and respect.

People and staff told us they thought the service was well led. Staff told us they were supported by the registered manager and there was an open and inclusive ethos within the service. The provider told us the aim of the service was to, “Promote independence” and, “Ensure everyone is able to achieve their full potential.”

The registered manager and the provider were experienced in working with people living with Korsakov’s syndrome and providing person centred care. The CQC had been informed of any important events that occurred at the service, in line with current legislation.

The registered manager and other senior staff regularly carried out audits to identify any shortfalls and ensure consistent, high quality, personalised care.