CQC report explained · a residential care home
What the CQC found at Elizabeth House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Good overall, but inspectors found that safety needed improvement because staffing, risk plans and some medicines procedures were not always reliable.
This was an unannounced focused inspection. Inspectors visited on 2 February 2023 and reviewed information, care records, staff files and management records. They spoke with people, relatives, staff and health professionals.
The overall rating remained Good. However, Safe was rated Requires Improvement. Inspectors found that people sometimes waited for help because there were not enough staff. Some risk assessments and care plans lacked important guidance, and some as-needed medicines were not given or recorded correctly.
Well-led was rated Good. The manager used audits, investigated incidents and shared learning with staff. People, relatives and staff generally said managers were approachable and that concerns were listened to.
This inspection only assessed Safe and Well-led. The other areas were not inspected and their previous ratings were used when calculating the overall rating.
Infection control
Inspectors were assured that the home had effective arrangements to prevent and manage infections, including the safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Learning from incidents
The manager investigated incidents and shared lessons with staff through noticeboards, handovers and team meetings.
“Lessons learnt were displayed on the staff noticeboard and managers checked staff were aware of the latest during their morning walkaround.” from the report
Approachable management
People, relatives and staff said they could raise concerns and access a manager. Inspectors found that quality monitoring systems were in place.
“People and families we spoke with were mostly complimentary of the service and staff.” from the report
Respect for people's choices
Inspectors found that the home worked within the principles of the Mental Capacity Act and used the least restrictive approach.
“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” from the report
Staffing levels
seriousPeople sometimes waited for help with toileting or getting to the dining room. Staff also reported being short-staffed at night. Extra staffing was agreed, but some recruitment was still ongoing.
“People told us, and we observed during our inspection, there were not always enough staff to meet people’s needs in a dignified way.” from the report
Incomplete risk information
needs fixingSome people were not always supported in line with their risk assessments. Behaviour support plans and other care records did not always give staff enough up-to-date guidance.
“People with behavioural support needs did not always have robust care plans and risk assessments.” from the report
As-needed medicines
seriousInspectors found an example where the wrong number of tablets was given. Staff also signed a medicines record before giving pain relief, and some guidance was not detailed enough.
“Staff had not always administered PRN medicines correctly.” from the report
Family feedback
minorRelatives' meetings were held, but attendance was very low. Most relatives spoken to by inspectors said they had not been asked for feedback.
“None of the families we spoke with had attended one and most said they had not been asked for feedback.” from the report
- 01How many care staff are now on duty during the day and at night, and has this changed since the inspection?
- 02How do you make sure people do not have to wait too long for help with toileting, moving around or getting to meals?
- 03How are risk assessments and behaviour support plans checked and updated when people's needs or behaviour change?
- 04What checks are now in place to make sure as-needed medicines are given at the correct dose and recorded only after they are administered?
- 05How are relatives currently asked for feedback, and what changes have been made in response?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection published on 10 March 2020. This explanation was written from the published report of 14 March 2023 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, March 2020
Elizabeth House rated Good; inspectors found kind, safe and well-managed care, with some minor gaps in activities and fire evacuation practice.
The home provides personal and nursing care for older people. At the inspection, 64 people were living there, although the home can support up to 108 people.
Inspectors visited without warning on 10 and 14 February 2020. They spoke with people, relatives and staff, observed care, and checked care files, medicines, staff records, complaints and quality checks.
All five areas were rated Good. The report says the home had improved since the previous inspection in January 2019, when all five areas were rated Requires Improvement. The home had made changes to safety, staffing, activities and the environment.
People felt safe
People and relatives told inspectors they had no safety concerns. Staff understood how to recognise abuse and raise concerns.
“People told us they were safe and had no concerns about their safety whilst living at Elizabeth House.” from the report
Kind and respectful care
Inspectors observed good relationships between people and staff. Staff were attentive and supported people with dignity, comfort and independence.
“Throughout both days of inspection observations showed people received person-centred care and had a good rapport and relationship with the staff who supported them.” from the report
Improved management
The report describes clear improvements since the previous inspection. Staff and relatives reported that management was more consistent and accessible.
“Relatives told us they had seen improvements since our last inspection in January 2019.” from the report
Good support with food and health
People spoke positively about the food and dining experience. Staff monitored nutrition risks and worked with healthcare professionals when needed.
“People had access to enough food and drink throughout the day and meals were nicely presented.” from the report
Fire evacuation drills
needs fixingStaff took part in regular fire drills, but the drills did not include using the fire evacuation equipment. Families should ask how this will be addressed.
“Although staff were aware of the service's fire procedures and knew what to do in the event of an emergency and participated in regular fire drills, the latter did not include using fire evacuation equipment.” from the report
Activities were sometimes cancelled
minorPeople said some bar activities occasionally did not happen. They were not always told and sometimes waited without knowing what was happening.
“However, people told us occasionally these did not take place and they were not always informed and were left sitting in the bar waiting for something to happen.” from the report
- 01How often do you practise using the fire evacuation equipment, and when was the last full evacuation drill?
- 02What do you do when a planned activity is cancelled, and how are residents and relatives told?
- 03How will you make sure the improvements found since January 2019 continue over time?
- 04How are changes in a person's care needs recorded and shared with all staff?
- 05How can relatives raise a concern, and how will they be kept informed about the response?
This was an unannounced comprehensive inspection covering the home, the care provided and all five CQC key questions. This explanation was written from the published report of 11 March 2020 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.
Every inspection of Elizabeth House
8 rated inspections over 8 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- February 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2018Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: InadequateWell-led: Inadequate
- May 2018Goodstayed GoodSafe: Requires improvementEffective: GoodWell-led: Good
- March 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Inspected but not ratedSafe: Requires improvementResponsive: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 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.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 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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