Elizabeth House Care Home Adults

At our last inspection on January 2017 we found five breaches of legal requirements. These were breaches of Regulation 12 because the management of medicines was not safe: Regulation 11 because the principles of the Mental Capacity Act 2005 had not been followed: Regulation 17 because there was a lack of effective governance processes and Regulation 18 because staff had not received regular supervision, appraisal or training to effectively undertake their role. We also found a breach of Regulation 18 of the Care Quality Commissions (Registration) Regulations 2009 because the registered persons had not always notified CQC of significant events that happened in the home. The provider was required to send us an action plan telling us what they would do to meet the requirements of the law. They sent this to us and we saw at this inspection improvements had been made.

Elizabeth House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Elizabeth House provides support for up to 20 people with mental health issues and/or learning disabilities. It consists of two large terraced houses knocked into one, situated in a quiet residential area of Portsmouth. The home has 18 bedrooms, two of which are for two people to share. The home has four floors. Offices and meeting rooms are on the lower ground floor; the kitchen, two lounges, the dining room, a smoking room and some bedrooms to the ground floor; and other bedrooms and bathrooms on the first and second floor. There was a stair lift on one short section of stairs between the first and second floor. On the day of inspection there were 18 people living at the home.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service complied with the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLs), and people were encouraged to make choices about their day to day life. However, we found that the recording of mental capacity assessments needed to be improved and we have made a recommendation about this.

People and staff told us they lived and worked in a safe service. All staff had undertaken training in safeguarding adults from abuse, they displayed good knowledge on how to report any concerns and were able to describe what action they would take to protect people from harm.

Risks associated with people's care were well known by staff, clearly documented in people's care plans and well managed. Environmental risks were assessed, monitored and measures had been taken to reduce these. The home was clean and infection control procedures were in place.

The management of medicines had improved and was safe.

There were sufficient numbers of staff to meet people's needs and to keep them safe. The provider had effective recruitment procedures in place and carried out checks when they employed staff to help ensure people were safe. Training for staff had improved and staff had the necessary skills to care for people appropriately. Staff were well supported through induction, supervision and appraisal systems.

People told us they received care and support that was very good and was delivered in a way that met their needs and preferences. Staff treated people with dignity and respect and people were supported to be as independent as possible.

People had enough to eat and drink and were complimentary about the food on offer.

People were aware of how to raise a complaint and we saw that complaints had been investigated and resolved. Feedback was encouraged from people, staff and other health professionals and this was used to improve the service.

People and staff said the management of the service was very good. Quality assurance processes had improved and the safety and quality of the service was effectively monitored.

The five questions we ask about services and what we found