CQC rates two Hertfordshire adult social care services inadequate for a second time

Published: 3 August 2022 Page last updated: 5 August 2022

Two services run by the St Elizabeth’s Centre in Much Hadham, Hertfordshire, have been rated inadequate for a second time by the Care Quality Commission (CQC) and remain in special measures, following inspections undertaken in June and July.

St Elizabeth’s Care Home with Nursing specialises in caring for people living with epilepsy, associated neurological disorders, learning disabilities and autism and other complex medical conditions.

St Elizabeth’s Domiciliary Care Agency provides supported living for people living with epilepsy; associated neurological disorders, learning disabilities and autisim.

Both services were rated inadequate and placed in special measures in March, following inspections in November 2021 where CQC identified concerns about people’s safety and standards of care being provided.

The latest inspections were carried out to assess whether improvements had been made and to seek assurance that people using the services were safe. CQC found that there had not been sufficient improvement and there continued to be widespread areas of concern.

As well as being rated inadequate overall, both services were rated inadequate for being safe, effective, and well-led. The key questions of whether the services are caring and responsive were not assessed, due to the inspection being focused on specific areas of concern.

The Trustees of St Elizabeth’s issued a statement on 21 July 2022 to announce  their intention to close St Elizabeth’s Care Home with Nursing later this year stating they were unable to safely staff the service or to meet the required standards.

Louise Broddle, CQC head of inspection for adult social care, said:

“Following the inspections in November 2021 we gave feedback to the provider identifying areas where significant improvements were needed to ensure people’s safety and quality of life. At our recent inspections although we found that some improvements had been made, there continued to be a lack of focus on people’s quality of life and we identified continued concerns in relation to people’s safety. There was a continued lack of person-centred care at both services.

We are mindful of the impact of the COVID-19 pandemic and the staffing shortages within the care sector on social care services. We took account of this when considering what  action was necessary and proportionate to keep people safe as a result of our inspection findings.

The response from leaders of The St Elizabeth Centre was not sufficient in developing the strategies and systems needed to improve people’s care or to address the issues relating to the culture of the service .

We understand that the announcement of the closure of St Elizabeth’s Care Home with Nursing will be causing anxiety and uncertainty to people using the service and to their families and we would encourage people to use the support and advise being offered by St Elizabeth’s and by the Local Authorities involved to understand their options.

We will continue to monitor both services and to work with the provider and Local Authorities to prioritise the wellbeing and safety of people using the service.”

The latest inspections found:

  • There weren’t enough appropriately skilled staff to meet people’s or keep them safe
  • The culture of the service was not in line with good practice for services for people with a learning disability and autistic people
  • People’s care plans didn’t always reflect their needs, preferences and aspirations
  • People weren’t always supported have choice and autonomy over their day-to-day lives
  • Decisions that restricted people weren’t always made in their best interests
  • Risk assessments weren’t always current or accurate
  • Accidents and incidents weren’t always followed-up and learned from, which meant people continued to receive poor care
  • Management hadn’t addressed safety concerns in a timely way.


  • The leadership of the services had been open and honest about the findings of the recent CQC inspections and had communicated these with staff, people living at the service and their relatives
  • Staff felt supported by managers
  • The leadership of the services were working closely with other professionals to help provide improved support to people
  • Inspectors received positive feedback from several of the people living at the services and their relatives.

The full findings of the reports can be found on the CQC website.

St Elizabeth’s Care Home with Nursing

St Elizabeth’s Domiciliary Care Agency

Contact information

For enquiries about this press release, email regional.engagement@cqc.org.uk.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.