Elizabeth House

During the assessment we spoke with people who received care from the service and their relatives; healthcare professionals linked to the service. We spoke with staff including the registered manager, the deputy manager, housekeeper, training manager and care staff.

This was a responsive inspection of two key questions triggered by our ongoing monitoring of the service.

Staff understood risks associated with people’s care, but some care records showed effective monitoring did not always take place as required.

Staff had access to ongoing training to develop their skills however it was not always clear from training records if all required training had been completed and there was no training policy.

The provider’s supervision policy stated there should be 3 supervisions and 1 appraisal per annum. However, Regular supervisions were not always completed.

We found concerns in relation to governance; the provider’s audits were not sufficiently detailed to ensure a robust system of oversight were taking place. Audits had failed to identify the concerns we found at this inspection. We found concerns related to incidents and accidents, and the lack of consistent investigation and analysis when things had gone wrong.

Processes were in place to help keep people safe and protect them from harm.

Equipment checks took place regularly to support people’s needs and ensure they were kept safe.

Staff administered medicines as prescribed to support people’s healthcare needs.

Cleaning of the home took place regularly and systems in place supported infection prevention and control.

At our last inspection, the rating for this service was Good (published 01 March 2019). The rating following this assessment has changed to Requires Improvement.

At this assessment we found 1 breach in relation to good governance; we have requested the provider send us an action plan in response to the concerns found at this assessment.

The registered manager was responsive to our findings and started taking immediate action to make improvements at the service.

People and/or their family members were involved in the assessment of people’s needs to ensure these could be met at the service.

Assessments considered people’s individual communication needs as well as personal and healthcare needs. People’s care was regularly reviewed however we found some care records were inaccurate or had missing information.

People’s privacy and dignity was respected by staff. People had enough to eat and drink to stay healthy and had a choice of meals.

Special diets were made available to those who required them. People had access to some activities of interest to them, to stay physically and mentally active.

People felt at ease to raise any concerns if they needed to and were confident action would be taken and improvements made.

People knew staff well. Records of people’s needs were shared (as appropriate) with other agencies to support the best outcomes and ensure the safe transition of people when moving services or attending hospital appointments.

People told us staff understood their care and treatment needs, and advised they were asked for their consent before care was provided. People spoke positively of living at the home and of the staff including management staff. People said they were treated with patience and respect.

One person told us, “The staff treat me very well; they are always here to do whatever I want.” People made daily living choices related to their care and support, and were encouraged to maintain relationships with family and friends. Staff worked to reduce health and care inequalities through training and feedback.