We carried out a review of the data available to us about Elliott House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Elliott House, you can give feedback on this service.
Elliott House is a residential care home providing the regulated activity personal and nursing care to up to 11 people. The service is provided from purpose-built accommodation and provides support to people with a mental health need and or living with a learning disability or Autism. At the time of our inspection there were 11 people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance the CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right Support:
Improvements had been made to records. Records were detailed and gave guidance to staff, so people received care that was centred and tailored to each individual.
Improvements had been made to medicines management. Staff followed effective processes to assess and provide the support people needed to take their medicines safely. Staff contacted health professionals when people’s health needs changed.
There were sufficient staff to support people safely.
People were provided with a variety of opportunities to be part of the community. They were supported to make choices and achieve their aspirations.
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.
Right Care:
People were provided with person-centred care that enabled them to develop skills and behaviours to live more independent lives. Care was person-centred and promoted people’s dignity, privacy and human rights.
People were complimentary about the care provided by staff. They trusted the staff who supported them. They said staff were kind, caring and supportive of people and their families. A person told us, “I love the staff, they respect me.” People were supported to maintain contact with their families.
Staff had received safeguarding training and were clear on how and when to raise their concerns. Where appropriate, actions were taken to keep people safe.
Right Culture:
The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives.
Systems were in place to ensure the right culture was being promoted that people’s human rights were respected and their opinions were listened to and valued.
The home had a new registered manager since the last inspection and a management team who had good knowledge of people’s needs and clear oversight of processes in the home. There was a positive atmosphere at the service. Staff spoke very positively about working at the service and the people they cared for. Staff said the registered manager was very approachable and they were supported in their role.
A governance system was in place to monitor the quality of the service through audits and feedback received from people, their relatives and staff. Improvements had been made since the last inspection to ensure people received safe and person-centred care. Processes were in place to manage and respond to complaints and concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 19 October 2021).
The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that information was made available in an accessible format for people who did not read, staff should receive specialist training to give them more insight into the needs of people they supported and the environmental design should meet the Right Support, Right Care and Right Culture guidance. At this inspection we found the provider had acted on most of our recommendations to improve the quality of service provision. The recommendation regarding replacing the electronic gate was in the process of being actioned.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 19 August 2021. Breaches of legal requirements were found.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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 Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elliott House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Elliott House is a care home registered to provide accommodation and personal care for up to 11 people. At the time of the inspection, 11 people were living there.
People’s experience of using this service and what we found
Risks were not always correctly managed. Risk assessments were not regularly reviewed and updated. Information about risk management was not easily available to staff. Medicines were not always managed safely.
Fire safety of the building had not been appropriately managed. Risk that had been identified in 2019 had still not been addressed. This meant that people had been placed at risk and as a result the fire service had taken enforcement action against the provider.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The registered manager had not ensured people’s capacity to make decisions about their care was properly assessed or recorded.
People’s support plans were not always comprehensive or up to date and therefore did not accurately reflect people's needs.
Staff training was not fully up to date. Some training that was relevant to the people living in the home had not been completed or was out of date. We have made a recommendation about this.
The environment did not meet the current best practice guidance in respect of homes of this type. We have made a recommendation about this.
Information was not always available in a format that was easy for the people living at the home to understand. We have made a recommendation about this.
Management checks had not identified the issues we found.
There were sufficient staff to meet people’s needs. Staff felt well supported and new staff were recruited safely.
People we spoke with told us that they felt safe living in the home. One person told us, “The staff are all great, it is the best staff team I have ever had.” Relatives were very happy with the support their family members received.
People were supported to see relatives and encouraged to join in a wide variety of activities both inside and outside the home.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, Right care, Right culture. Staff respected people's privacy and dignity, seeing them as individuals regardless of their health condition or day to day needs. People were given opportunity to engage in meaningful activities, interests and hobbies. However, the model of care did not do everything possible to maximise independence. Support plans were not always person centred and there was no clear framework to help people set and then achieve their goals.
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 the service under the previous provider was good, published on 29 January 2019.
Why we inspected
The inspection was prompted in part due to concerns received about another location owned by the same provider. A decision was made for us to inspect and check whether similar concerns were present at this location.
We have found evidence that the provider needs to make improvements. Please see the full report for more details.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to regulations 12, safe care and treatment and 17, good governance 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice:
¿ Arrangements were in place to prevent visitors from spreading and catching infection. Only essential visits could take place at the time of inspection. Visitors to the home were screened for potential infection.
¿ The home supported social distancing wherever possible. Seating was arranged in the lounge and dining room to avoid close contact between people. Each floor was classified as a separate zone. Each zone had its own entrance.
¿ The home had no capacity to admit anyone. The registered manager explained people were only admitted with a robust transition plan.
¿ The home was well-stocked with supplies of personal protective equipment (PPE). Staff were trained on how to safely use PPE and were observed to be wearing PPE appropriately.
¿ Staff and people were regularly taking part in the COVID-19 testing programme.
¿ The home was clean, tidy and well ventilated. Staff regularly cleaned points which were frequently touched by people.
¿ One person told us the staff were excellent at supporting their well-being. Staff created a positive atmosphere in the home.