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Inspection summaries and ratings from previous provider

Overall summary & rating


Updated 4 December 2018

This inspection took place on 23 and 24 October 2018. It was an announced visit to the service.

Lady Elizabeth House provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented from a housing association and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. Nineteen people were being supported by this service at the time of our inspection. People varied in age from younger adults to older persons and had a range of personal care needs and levels of independence. Each person had their own self-contained flat. There was a communal lounge and dining room people could use and an on-site day service run by the provider. Some people received personal care from other agencies as well as staff at Lady Elizabeth House.

We previously inspected the service in August 2017. The service was rated ‘requires improvement’ at that time. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘effective’ and ‘well-led’ to at least ‘good’. On this occasion, we found improvements had been made to people’s care. These included notification to us of incidents of abuse, assessment of people’s mental capacity and recording when medicines for occasional use had been offered to people. A deputy manager position had been introduced at the service and feedback showed this arrangement was working well.

The service had a registered manager in post. A registered manager is a person who has 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.

We received positive feedback about people’s care. Comments included “Without any sort of a lie I can say the care is actually excellent,” “The carers are exceptional” and “They are very friendly to (us). They laugh and joke and look really happy.”

Staff received the support they needed to meet people’s needs, through supervision, training and a structured induction. Appraisals also took place to assess staff performance. Thorough recruitment procedures were used.

Each person had a care plan which outlined the support they required. These had been kept up to date and were accompanied by risk assessments, to minimise the likelihood of injury or harm. Staff supported people with their medicines and nutritional needs, where this was part of their care package.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Quality of care was monitored by the provider through visits to the service, audits and surveys. People were asked for their views in tenants’ meetings and during quality reviews. Complaints were responded to and actions were taken to make improvements, where necessary. The service worked well with other agencies and departments to make sure people received effective and continuous care. This included the housing association and other care providers.

Inspection areas



Updated 4 December 2018

The service was safe.

People were protected from harm because staff received training to be able to identify and report abuse. There were procedures for staff to follow in the event of any abuse happening.

People�s likelihood of experiencing injury or harm was reduced because risk assessments had been written to identify and minimise areas of potential risk.

People were supported by staff with the right skills and attributes because robust recruitment procedures were used by the service.



Updated 4 December 2018

The service was effective.

People received safe and effective care because staff were appropriately supported through a structured induction, regular supervision and training.

People were encouraged to make decisions about their care and day to day lives. Decisions made on behalf of people who lacked capacity were made in their best interests, in accordance with the Mental Capacity Act 2005.

People received the support they needed to attend healthcare appointments and keep healthy and well.



Updated 4 December 2018

The service was caring.

People were supported to be independent and to access the community.

People�s views were listened to and acted upon.

Staff treated people with dignity and respect and protected their privacy.

People had the opportunity to share their views and receive updates about the service.



Updated 4 December 2018

The service was responsive.

People�s preferences and wishes were supported by staff and through care planning.

There were procedures for making compliments and complaints about the service. Changes were made, where necessary, to improve care.

People�s wishes were documented in their care plans about how they wanted to be supported with end of life care.

The service responded appropriately if people had accidents or their needs changed, to help ensure they remained independent.



Updated 4 December 2018

The service was well-led.

The provider monitored the service to make sure it met people�s needs safely and effectively.

Improvement had been made to the reporting of serious occurrences or incidents to the Care Quality Commission. This meant we could see what action they had taken in response to these events, to protect people from the risk of harm.

People were cared for in a service which was open and transparent when things went wrong.