Elizabeth House

Elizabeth House is a residential care home providing personal care to up to 35 people. The service provides support to older people who may have dementia. At the time of our inspection there were 16 people using the service.

We assessed all quality statements in safe and well-led and 1 quality statement from the effective key question, called Delivering evidence-based care. For quality statements we have not assessed at this assessment, we have used the rating from previous assessments to help calculate the rating of the key question.

There was now 1 registered manager in place. An external consultant had previously been involved in supporting the provider and a registered manager but they had now taken a step back so the service could operate independently. During the last inspection we found continued breaches in the regulations. The provider was in breach regarding the physical environment, safe managing of medicines and good governance. At this inspection, the provider continued to be in breach regarding good governance. Whilst there had been many improvements, including improvements to the management of medicines and some improvements to the environment, there continued to be concerns with the provider’s oversight and the provider’s responsiveness when concerns were identified. Despite this, the registered manager was monitoring the quality and safety of the service and had made many improvements.

The registered manager monitored incidents in the service and took action to learn from these. The registered manager worked in partnership with other health professionals to try to keep people well. People’s health conditions were monitored. However, 1 person had missed an urgent medical appointment as this had not been effectively handed over. People were protected from abuse by staff who understood their safeguarding responsibilities. Staff knew people well, but care plans needed to reflect people’s current needs to reduce the risk of error. Improvements were needed to the environment to ensure it was safe and appropriate for those using the service, and action should be prompt when concerns were identified. People were protected from the risk of cross infection. There were enough safely recruited staff who had the skills and experience to keep people safe. Improvements were needed to the management of medicines. However, stock levels matched records which was an improvement. We continued to receive mixed feedback about the food. However, people were supported with this in a safe way. The culture of the service had improved; staff and the management team were more person focused. The registered manager was dedicated to making improvements to the service. There had not yet been involvement from people or relatives in everyone’s care plans, but work was ongoing to address this. People, relatives, staff and professionals felt able to approach the registered manager and found them responsive to feedback. The provider valued diversity in their workforce. The provider did not always discharge their duty to effectively and regularly monitor and evidence the monitoring of their service. However, there were now more embedded systems in place to monitor the quality and safety of people’s care, completed by the registered manager. The provider understood their duty to collaborate and work in partnership. The provider focused on continuous learning and improvement.