St Elizabeth's Health Agency

St Elizabeth's Health Agency provides intensive epilepsy, health and therapeutic support to children and young people with a learning disability using the centre’s services. Nurse led clinics are also run for younger people who use the school, college and the children's care home on site. St Elizabeth’s Health Agency provide nursing care to 22 children and young people at the time of the inspection.

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

Right support

Children and young people were safe and protected from potential abuse because the staff knew how to identify and report any concerns relating to the risk of abuse. Risks to their health, safety and well-being were assessed, and measures were put in place to remove or reduce the risks. Children and young people were supported by nurses who had been safely recruited.

Nurses supported children and young people to make decisions about their health and wellbeing by following the correct legislation. Nurses communicated with the children and young people in ways that met their needs. for example, using social stories. Nurses supported children and young people to play an active role in maintaining their own health and wellbeing

Right care

Children and young people had a robust assessment to help ensure their needs and preferences could be met. Care plans were developed from these assessments for each identified need.

Nurses protected and respected children and young people’s privacy and dignity. They understood and responded to their individual health needs.

The nurses knew the young people and children well and were able to promptly identify when their needs changed, supporting them to get the right medical help they needed.

Right culture

The provider needed to develop a robust governance system to ensure that the nurses were working in line with best practice and that there was enough skilled managerial oversight of the service. The registered manager did not have clinical direction from the provider and quality checks were not being made by the provider. This was something the registered manager was starting to develop with the provider.

External professionals and care workers said the nurses and the management team were always available and supportive.

The management team was committed to providing good quality nursing care to the children and young people they supported, (as well as the support to their care workers, ) and understood their responsibilities under the Duty of Candour to be open and honest with the everyone they supported.

Risk assessments were in place in most cases, which identified risks children and young people faced and how nurses should manage these. There were further developments required where not all health needs were identified in the risk assessment; however, nurses were aware of these health conditions.

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

Rating at last inspection

This service was registered with us on 10 October 2020 and this is the first inspection. We conducted a targeted inspection published 03 August 2022, however, we did not rate the service at that inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified a recommendation that the provider reviews the internal clinical oversight for the service.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

St Elizabeth’s Health Agency is part of the St Elizabeth Centre. St Elizabeth Centre is located on a 65-acre site and comprises of a school and children’s home, college, domiciliary care agency, adult residential and nursing services with accommodation and the health agency. The centre provides education, care and nursing support for people of all ages who have epilepsy and other complex needs. St Elizabeth’s Health Agency provide nursing for the school and children’s residential care home. At the time of the inspection they provided nursing support to 36 children.

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

We found improvements needed to be made to the documentation of the medicine administration records and associated records. People’s records did not always give clear instructions which could leave the staff who were administering the medicines at risk of making an error.

The registered manager had identified areas of improvement with the medicine records and systems through their auditing and action plans. They were working with outside professionals, the home and the staff to improve this.

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

Rating at last inspection

This service was registered with us on 03 October 2018 and this is the first inspection. The last rating for the service under the previous provider was good (published 22 June 2018)

Why we inspected

The inspection was prompted in part due to concerns received about medicines management. A decision was made for us to inspect and examine those risks. The overall rating for the service has not changed following this targeted inspection and remains good.

We undertook this targeted inspection to see if people received safe care with their medicines. We use targeted inspections to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.