Archived: Elizabeth House Residential Care Home

Updated 4 July 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors on the first day, and one inspector on the second day.

Service and service type

Elizabeth House Residential Care Home 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager is also one of the partners for the provider.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service. We spoke with four care staff and two staff involved in housekeeping and maintenance. We spoke with the registered manager. We looked at a range of records related to how the service was managed. These included five people’s care records and how medicines were managed for people. We also looked at three staff recruitment and training files, and the provider’s quality auditing system. During the inspection visit we asked the registered manager to send us additional evidence about how the service was managed, and they did this.

Updated 4 July 2020

About the service

Elizabeth House Residential Care Home is a care home which can provide personal care for up to 16 people. Accommodation is provided over two floors. The service supports people who have needs associated with ageing or are living with a dementia related illness. At the time of this inspection five people were using the service.

People’s experience of using this service and what we found

The service was not safe. The provider and registered manager failed to ensure risks to people were assessed and managed. Risks to people were not always assessed, reduced and monitored. The provider had not ensured they followed safe recruitment practices. Medicines were not managed safely.

The service was not clean. Equipment used as part of people’s care was not clean. Food was not consistently stored safely. Similar issues from our last inspection had not been acted on. Lessons were not learnt when things went wrong. There was no evidence of learning from accident or incidents. Staff told us they knew how to report concerns about abuse. However, we observed care practices that put people at risk which staff had not reported.

People continued to be put at risk because the provider and registered manager failed to ensure suitable quality assurance checks identified issues with care and support. Audit systems were not comprehensive or robust. Systems and processes to assess risk and monitor quality were insufficient and ineffective in driving improvements.

People were put at risk of harm as the registered manager did not demonstrate they had the required skills and competency to manage the service effectively and safely. The provider and registered manager had failed to act on the issues identified on our last two inspections.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Inadequate (published 11 March 2020) and there were multiple breaches of regulations. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We received concerns from the local authority in relation to risks associated with people’s health conditions, management of medicines, unsafe recruitment practices, and unsafe food storage. As a result, we undertook a focused inspection to review the key questions of Safe and Well-Led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has not changed. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elizabeth House Residential Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified continued breaches in relation to Regulations 7, 12, 17, and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Please see the action we have taken at the end of this report.

Following representations and appeals, CQC have acted to cancel the provider and registered manager's registration.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. We will work with the local authority to monitor progress. If we receive any concerning information we may inspect sooner.

Special Measures:

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.