CQC report explained · a nursing home
What the CQC found at Queen Elizabeth House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safeguarding systems, risk assessments, safe medicine arrangements and suitable emergency plans. Some important risk information was not easy for staff to access, especially with high agency staff use.
- Effective?
- Good
- People had trained staff, health assessments, access to health professionals and support with food and fluids. Inspectors noted some concerns about varying nursing skills and a missing mental capacity and best-interest process before some blood tests.
- Caring?
- Good
- Permanent staff were observed to have positive relationships with people and to support them respectfully. Some agency staff were less engaged, and one was heard telling a distressed person to stop.
- Responsive?
- Good
- Care plans described people's individual needs, communication methods, activities and epilepsy protocols. Some relatives felt activities were limited by transport and staffing, and care plan reviews repeatedly recorded only that there was no change.
- Well-led?
- Good
- The manager was described as approachable and responsive, and the home had systems for audits and feedback. However, actions from audits were not routinely completed or signed off, and some records were difficult to use.
What inspectors found, October 2018
Queen Elizabeth House was rated Good; inspectors found kind, safe care, but staffing continuity and record checks needed improvement.
Inspectors visited without notice on 18 and 19 September 2018. They spoke with people, relatives, staff and health professionals, observed care, checked the building and reviewed care, medicine, staffing and training records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found safeguarding systems, suitable staffing levels, safe medicine practices and person-centred care plans.
There were some weaknesses. The home had many staff vacancies and relied heavily on agency staff. Some records, risk information and audit follow-up were incomplete or difficult to access. The manager agreed to address these issues, and sent CQC an action plan and evidence of some improvements after the inspection.
Safety systems
The home had systems to safeguard people, manage risks and support safe medicines, equipment and evacuation.
“Systems were in place to safeguard people. Risks to people were identified and managed.” from the report
Kind permanent staff
Relatives and inspectors described permanent staff as kind, respectful and able to communicate with people who had limited or no verbal communication.
“Wonderful, attentive, caring and knew how to support and communicate with their family members.” from the report
Personalised support
Care plans covered personal care, medical needs, life skills, activities and communication. People were supported to make everyday choices.
“People had person-centred care plans in place. They provided clear guidance on the support people needed with aspects of their care such as personal care, medical needs, life skills and activities.” from the report
Accessible management
The manager was experienced and staff and relatives said they could raise concerns and receive a response.
“The registered manager was experienced in their role. They were supportive and acted as a positive role model to staff.” from the report
Heavy agency staff use
needs fixingThere were 20 full-time staff vacancies, so the home used many bank and agency staff. The manager recognised that this made continuity of care difficult, and relatives raised concerns about some agency staff.
“Due to the high staff vacancy levels a number of bank and agency staff were used on each shift.” from the report
Incomplete records and checks
needs fixingSome health and safety checks, medicine records and medicine competency tracking were incomplete. The manager sent evidence after the inspection that action had been taken.
“We found gaps in health and safety checks, a medicine record was not updated to reflect that medicine was to be administered via a feeding tube, medicine competency assessments were not tracked” from the report
Audit actions not followed through
needs fixingThe home carried out audits, but actions were not routinely completed, followed up or signed off. This could mean that identified improvements were missed.
“Actions arising from the audits were not routinely completed.” from the report
Uneven agency engagement
needs fixingSome agency staff did not engage with people, and one was heard speaking inappropriately to a distressed person. The manager said this would be addressed.
“An agency worker was heard telling a person who was distressed to "stop it.” from the report
Capacity process missing in some cases
needs fixingFor some people who could not agree to a blood test, the required mental capacity assessment and best-interest meeting had not taken place beforehand. The manager had identified this and was working to address it.
“We saw for some people who lacked capacity to agree to a blood test a mental capacity assessment and best interest meeting had not taken place prior to the procedure.” from the report
- 01How many permanent staff vacancies are there now, and how do you make sure agency staff provide consistent care?
- 02How do staff quickly find each person's epilepsy, choking and other high-risk guidance?
- 03What changes have been made to medicine records and checks of staff competency since the inspection?
- 04How do you make sure audit actions are completed, followed up and signed off?
- 05What activities and outings are currently available, and how are transport and staffing arranged for them?
This was an unannounced inspection covering all five CQC questions, with observations, discussions and checks of care, medicine, staffing and management records. This explanation was written from the published report of 17 October 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.
Every inspection of Queen Elizabeth House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 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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89 live-in carers within about an hour of Buckinghamshire
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 £1,020 to £1,300 a week. 79 can care for a couple. 13 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
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.