CQC report explained · a residential care home
What the CQC found at Elizabeth House Care Home Adults
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, medicines were managed safely, risks were documented and managed, and there were enough suitably recruited staff. The home was clean and infection control procedures were in place.
- Effective?
- Good
- Staff had the training, supervision and support needed for their roles. People's food, drink and healthcare needs were met, although records of some mental capacity assessments needed improvement.
- Caring?
- Good
- Staff were kind and caring and respected people's privacy, dignity, choices and independence. People were supported to express their views and maintain family contacts.
- Responsive?
- Good
- Care plans were personalised, regularly reviewed and gave staff information about people's needs and preferences. Activities were based on individual interests, and complaints were investigated and resolved.
- Well-led?
- Good
- Quality and safety were monitored through audits and checks. People, relatives, staff and health professionals were encouraged to give feedback, and the home had an open and inclusive atmosphere.
What inspectors found, July 2018
Rated Good; inspectors found safe, kind and personalised care, with better management since five breaches at the previous inspection.
Inspectors visited the home without notice on 4 June 2018. They spoke with six people, two relatives, the manager, the provider and three staff members. They looked at care records, staff records, complaints, audits, policies and other documents.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that medicines, staffing, safeguarding, risk management and infection control were safe.
People were treated with kindness and respect. Staff knew people's needs and preferences, supported their independence, provided suitable food and helped people access activities and healthcare.
The home had improved since the January 2017 inspection. The previous five legal breaches had been addressed. Inspectors still recommended clearer records of mental capacity assessments, but they found this had not negatively affected people.
Safer medicines
Inspectors found that the earlier problems with medicine storage, training and records had been addressed. Medicines were stored securely, records were clear and staff had been assessed as competent.
“At this inspection we found the provider had taken sufficient action to achieve compliance with this regulation.” from the report
Kind and respectful staff
Staff knew people well and supported them with patience, compassion and respect. They promoted privacy, dignity and independence.
“We observed interactions between staff and people and witnessed numerous examples of staff providing support with compassion and kindness.” from the report
Personalised support
Care plans included people's needs, preferences, life histories and views. Staff used this information to provide support around each person's choices.
“Care plans were developed from the pre-assessment and were person centred.” from the report
Improved staff support
Training, supervision and appraisals had improved since the previous inspection. Staff said they felt supported and had opportunities to develop their skills.
“Staff told us they received regular supervisions and had an annual appraisal.” from the report
Listening and responding
The home encouraged feedback from people, relatives, staff and health professionals. Complaints were investigated, resolved and reviewed for patterns.
“People knew how to complain and complaints had been investigated, resolved and analysed to determine any trends.” from the report
Mental capacity records
needs fixingSome mental capacity assessments were not recorded before applications for Deprivation of Liberty Safeguards. Inspectors recommended that the records should be clearer, although they found the law was understood and followed in practice.
“However, the records of these assessments needed to be clear and we recommend the registered persons seek guidance from a reputable source to ensure this is done appropriately.” from the report
Tired surroundings
minorThe communal areas were described as dated and tired. The provider had started updating the décor and said a new carpet was planned.
“Communal areas were dated and tired but welcoming.” from the report
- 01How are mental capacity assessments recorded now, particularly before any Deprivation of Liberty Safeguards application?
- 02What changes have been made to the communal areas, carpets and furniture since this inspection?
- 03How do you check that medicines remain stored, administered and recorded safely?
- 04How are staffing levels adjusted when several people have appointments or need support to go out?
- 05How do you use complaints and feedback to make further improvements?
This was an unannounced inspection looking at the overall quality of the home and all five key questions; the previous January 2017 breaches were also checked for improvement. This explanation was written from the published report of 19 July 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2017
Elizabeth House Care Home Adults was rated Requires Improvement; inspectors found kind care but serious weaknesses in medicines, staff training and oversight.
Inspectors visited on 16 and 17 January 2017. The first day was unannounced. They spoke with people, relatives, staff and health professionals, and reviewed care files, medicines records, staff records and the home's policies.
People were generally treated kindly and respectfully. Inspectors found enough staff, clean surroundings, good food and support with healthcare. Care plans were person-centred and people were involved in decisions about their care.
However, medicines were not always managed safely. Staff training and supervision were not up to date. Mental Capacity Act assessments were missing. The home did not regularly check the quality and safety of its care, and some incidents had not been reported to CQC.
The overall rating was Requires Improvement. Caring was rated Good. Safe, Effective, Responsive and Well-led were each rated Requires Improvement. The report says the provider must send CQC a report explaining what action would be taken, and CQC would check this.
Kind and respectful care
Inspectors saw positive interactions. People were supported with dignity, privacy and independence, and staff knew them as individuals.
“All interactions we saw were polite and respectful.” from the report
Person-centred care planning
People helped design and review their care plans. The plans recorded what people could do, the support they needed and their personal goals.
“This meant people's care plans were person-centred and they were regularly consulted about their content.” from the report
Food and health support
People had food choices, drinks and snacks throughout the day. The home supported people to attend appointments and worked with a range of health professionals.
“We found the food to be hot, tasty and plentiful.” from the report
Enough staff
People and relatives said there were enough staff, and inspectors' observations supported this. The staff team was stable and agency staff had not been used.
“Feedback from people and their relatives and our observations showed there were enough staff deployed at the home to meet people's needs.” from the report
Medicines were not managed safely
seriousInspectors found unclear medicines records, medicines left unsecured, and staff not always observing people taking their medicines. This was a breach of the regulations.
“This meant it was not clear if people had received their medicines as prescribed.” from the report
Staff training and supervision gaps
needs fixingRecords did not show that staff had received all necessary training. Staff had not received supervision or annual appraisals since 2015, and medicines training was especially out of date.
“This meant care workers had not had access to regular supervision and annual appraisal for over a year.” from the report
Mental capacity processes were not followed
seriousPeople's ability to consent to care and treatment had not always been assessed. Staff could not correctly explain the Mental Capacity Act and this was a breach.
“The home was not compliant with the Mental Capacity Act 2005.” from the report
Weak management checks
seriousThe home did not regularly audit medicines, complaints, accidents, incidents, care plans or daily records. This was a breach of the regulations.
“This meant there was no regular audit of medicines, complaints, accidents and incidents, or care plans.” from the report
Some incidents were not reported to CQC
seriousThe home had not notified CQC about some incidents, including a police call after a person went missing and incidents of abuse between people. This was a breach.
“Failure to make all appropriate statutory notifications to CQC was a breach of Regulation 18 (1) and (2) (e) (f) of the Care Quality Commission (Registration) Regulations 2009.” from the report
Recovery goals were missing
needs fixingCare plans did not include long-term recovery or rehabilitation goals. Inspectors recommended that the provider investigate evidence-based recovery models to support independence.
“This meant that the provider may have missed opportunities to support people to become more autonomous regardless of their age or diagnosis.” from the report
- 01What changes have you made to medicines administration, storage, recording and competency checks since this inspection?
- 02Have all staff completed the training needed for the people living here, and are supervision and appraisals now taking place regularly?
- 03Have you completed Mental Capacity Act assessments for everyone who may not be able to consent to their care and treatment?
- 04What regular audits do you now carry out for medicines, incidents, complaints, care plans and daily records?
- 05How are you supporting residents to set recovery, rehabilitation or independence goals?
This was an inspection of the overall service and all five questions, using discussions, observations and records including seven care files and seven people's medicines records. This explanation was written from the published report of 7 April 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Elizabeth House Care Home Adults
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- July 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Elizabeth House Care Home Adults →
- April 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Elizabeth House Care Home Adults →
- May 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £1,020 to £1,240 a week. 38 can care for a couple. 10 years' experience on average.
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