CQC report explained · a nursing home
What the CQC found at Elizabeth Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe medicines management, good risk assessments and appropriate infection control. They recommended stronger checks on applicants' conduct in previous care roles.
- Effective?
- Good
- People's needs were assessed and care plans were detailed. Staff supported nutrition, hydration, healthcare access and lawful decision-making.
- Caring?
- Good
- Staff were observed treating people with kindness, dignity and respect. People were supported to make choices about daily routines, food and personal care.
- Responsive?
- Good
- Care was personalised and activities included individual and group options. Staff knew people's histories, interests, communication needs and preferences.
- Well-led?
- Good
- The home had audits, management checks and systems for learning from incidents. Inspectors found that earlier governance problems had been addressed.
What inspectors found, August 2021
Elizabeth Lodge rated Good; inspectors found kind, safe and personalised care, with recruitment checks needing improvement.
This was an unannounced comprehensive inspection on 9 June 2021. Inspectors spoke with people, staff, a visitor, relatives and health professionals. They observed care and mealtimes, looked around the home, and checked care, medicines, staffing, infection control and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, clean surroundings, good infection control, detailed care plans and staff who knew people's needs and preferences.
There was one recommendation to improve recruitment checks. Two of five staff files did not contain enough information about conduct in previous care roles. The report also says one medicine room was too warm, but the home had already identified this and was taking action.
The previous rating was Requires Improvement, with breaches relating to dignity, person-centred care and governance. Inspectors found enough improvement had been made and the home was no longer in breach of those regulations.
Detailed personal care
Care plans covered people's physical, mental health, communication, nutrition and interests. Staff reviewed plans and risks every month.
“People's care plans were comprehensive and holistic addressing their needs and preferences in all aspects of their life” from the report
Kind and respectful staff
People were supported with dignity and were involved in everyday choices. Staff encouraged independence and respected people's decisions.
“Staff supported people in a respectful and caring way.” from the report
Safe medicines and infection control
Medicines records were accurate and medicines were stored safely apart from one temperature issue already being addressed. The home was clean and staff followed COVID-19 procedures.
“People received their medicines safely and as prescribed. Medicines Administration Records (MAR) were completed accurately.” from the report
Meaningful activities
A lifestyle team supported people with individual time and activities such as art, exercise, music and games.
“The home had a "lifestyle" team whose job was to support people to have meaningful days and enjoy activities.” from the report
Recruitment records
needs fixingTwo of the five staff files checked did not contain enough information about conduct in previous care roles. The report recommends following best practice for all new staff recruitment.
“two of the five staff files we examined did not contain sufficient information about their conduct in previous care roles.” from the report
Medicine storage temperature
minorOne medicine room was above the recommended storage temperature. The home had already identified this and was taking action to correct it.
“One medication room was above the recommended temperature for storing medicines safely.” from the report
- 01What changes have been made to check applicants' conduct with previous care employers?
- 02What was done to correct the medicine room temperature, and how is it monitored now?
- 03How do you make sure staffing levels remain suitable when staff are absent?
- 04How are activities planned for someone who cannot easily communicate their interests?
- 05How do you use relatives' feedback, including concerns about food or staffing?
This was an unannounced comprehensive inspection covering all five CQC questions, including infection prevention and control arrangements during the COVID-19 pandemic. This explanation was written from the published report of 6 August 2021 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, July 2019
Rated Requires Improvement; inspectors found safe care and good support with food and healthcare, but serious shortfalls in dignity, activities and management remained.
This was an unannounced inspection on 6 and 7 June 2019. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care, medicines, staff and management records.
The home was rated Good for Safe and Effective. People generally felt safe. Medicines were managed safely, staff had training, people had access to healthcare, and meals, drinks and snacks were available.
The home was rated Requires Improvement for Caring, Responsive and Well-led. Inspectors saw task-focused care, little conversation or stimulation, and gaps in support with baths and showers. The home had identified some of these problems but had not made enough progress since the previous inspection.
The overall rating fell from Good at the previous inspection, published in December 2016. The home breached regulations about person-centred care, dignity and respect, and good governance.
People felt safe
People and relatives generally said they felt safe and secure. Staff understood how to recognise and report safeguarding concerns.
“People and their relatives told us that they felt safe and secure living at Elizabeth Lodge.” from the report
Medicines were managed safely
Medicines records were generally complete, medicines were stored securely, and staff administering medicines had been trained and assessed.
“People were receiving their medicines safely and as prescribed.” from the report
Good access to food and healthcare
People had choices of meals, snacks and drinks. Inspectors found evidence that the home accessed doctors and other healthcare professionals when needed.
“Drinks, snacks and fruit were available to people throughout the day.” from the report
Some kind relationships
Inspectors saw kind and caring interactions in some units. People and relatives also described some staff as friendly, kind and respectful.
“During the inspection we did observe some kind and caring interactions between people and staff especially in particular units, namely 'Stuart' and 'Tudor'.” from the report
Too little interaction and stimulation
seriousPeople were sometimes left sitting in communal areas or in their bedrooms without meaningful activity, conversation or social contact. This was especially concerning for people who did not attend group activities.
“Where people remained in their bedrooms for most of the day, the only interaction that they received was when they required care and support.” from the report
Personal care was not always provided as wanted
seriousRecords did not show regular baths or showers for some people, even where this was their preference. Inspectors found examples of people receiving only bed washes or not being offered a bath or shower.
“Daily records for people did not evidence that they were being supported to have a bath or shower on a regular basis as per their choice.” from the report
Staff deployment
needs fixingCommunal areas were left unattended for periods of up to ten minutes, and bedroom checks did not always include social interaction. Inspectors recommended changes to staff deployment.
“Communal areas, where people were sat, were left unattended again for up to ten minutes at any one time.” from the report
Known problems were not fixed
seriousThe provider's audits identified issues, but inspectors found little or no progress in making the required changes. Problems identified at the previous inspection remained.
“The provider and registered manager had made little or no improvement or progress towards making the required changes to improve people's experiences.” from the report
Some records were incomplete
minorSupervision records were not always available, and records of some healthcare professional involvement were not consistently recorded or easy to find.
“However, supervision records were not always available to confirm supervision had taken place.” from the report
- 01What specific changes have you made to ensure people who stay in their rooms receive regular conversation, activities and stimulation?
- 02How do you record and check that each person receives baths or showers in line with their preferences?
- 03How have you changed staff deployment so communal areas are not left unattended?
- 04What progress has been made on the action plan following the three regulatory breaches?
- 05How do you make sure agency staff understand each person's needs and preferences?
This was an unannounced planned inspection covering all five CQC questions, and the report says the previous overall rating was Good with Responsive already rated Requires Improvement. This explanation was written from the published report of 17 July 2019 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 Lodge
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- August 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
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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At least 100 live-in carers within about an hour of Enfield
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 79 can care for a couple. 11 years' experience on average.
“Over the time he spent with them he got to know our parents very well and became like part of the family, even joining in family celebrations.”
“Charity would take Nan on holidays day trips and shopping adventures”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.