ST ELIZABETH

St Elizabeth is a residential care home providing personal care for up to 17 people aged 65 and over who may be living with dementia. At the time of the inspection there were 12 people living at the home.

The home accommodates people in one adapted building with two floors. There is a range of living areas. Bedrooms are spread across two floors; some have ensuite and some have shared bathroom facilities.

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

The service had made improvements to risk assessment processes and management systems which meant people were protected from the risk of avoidable harm. Staff had a good awareness of types of abuse, incidents they should report and how to provide safe support for people. People received their medicines as prescribed and infection control practices were robust.

The service worked with other healthcare organisations to ensure people had support to meet their physical and mental health needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were caring and compassionate. People were treated with kindness and respect. Staff understood how to promote independence and meet people’s individual needs. People described staff as “very good” and “lovely”.

There had been improvements to the activities available to people so that they were more personalised. Staff had more time to spend one-to-one with people, to prevent anxiety or distress and to keep people occupied. There had been no formal complaints in the past 12 months. People and their families were asked for their feedback regularly and were kept up to date.

Staff understood how to provide compassionate end of life care and knew people well, though advanced care plans were not detailed. This continued to be a recommendation for the provider to implement best practice.

The provider had improved connections with the local community and other stakeholders, particularly during the pandemic. There had been considerable improvements to the quality assurance in the service which meant any issues had been identified and there was a clear plan of action for continuous improvement. Staff, people and relatives fed back positively about the provider, the manager and the senior staff and felt there was a positive culture in the home.

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 requires improvement (published 1 May 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

At the last inspection of the service breaches of legal requirements were identified relating to person-centred care; need for consent; safe care and treatment; good governance and staffing. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We met with the provider and directed them to support available to make the required improvements.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Elizabeth on our website at www.cqc.org.uk.

Follow up

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

St Elizabeth is a residential care home that was providing personal care to 14 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

¿ We identified breaches in five regulations where the provider was failing to meet the fundamental standards people who use service have a right to expect.

¿ People’s risks were not always fully assessed, and management plans were not always detailed or up to date to ensure people were safe from the risk of avoidable harm. Medicines were not always managed safely and infection control procedures were not always followed.

¿ Staffing levels were not always high enough to keep people safe and to spend time on meaningful activity.

¿ People’s capacity to consent was not always assessed for relevant decisions about their care. People were subject to continuous supervision and were not free to leave as they wished, where people lacked capacity to consent to this arrangement, relevant authorisation had not been sought.

¿ People did not always receive personalised care that met their needs. Suitable adaptations had not been made to the premises to meet people’s needs relating to dementia, which affected their independence. People did not always have activities which met their needs and enabled them to engage. People’s personal history and current condition was not considered when planning activities which affected people’s quality of life.

¿ Quality assurance processes were not robust enough to ensure issues were highlighted and acted upon in a timely manner to prevent people being at risk of harm or poor-quality care.

¿ We have made recommendations relating to reviewing and implementing current guidelines and best practice and reviewing staff training to ensure this give staff required skills to meet people’s changing needs.

Rating at last inspection:

This is the first inspection since the service registered with a new provider on 28 March 2018.

Why we inspected:

This was a planned inspection which was due within 12 months of the service registering with CQC.

Enforcement:

For actions we told provider to take, please refer to the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

Until the provider can show they are compliant with the fundamental standards in the regulations, we will continue to monitor the provider's progress in line with services rated requires improvement. These procedures will include proportionate enforcement action, requesting an

agreed improvement plan with timescales, and meeting with the provider to monitor progress.

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