Queen Elizabeth Care Centre

Updated 31 March 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 4 inspectors and a specialist advisor.

Service and service type

Queen Elizabeth Care Centre is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Queen Elizabeth Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for one month and had submitted an application to register with CQC. We are currently assessing this application.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 7 relatives about their experience of the care provided. We also observed interactions between staff and a number of other people who used the service. We spoke with 8 members of staff including the manager, registered nurses, senior care workers, care workers, chef, activities lead. We also spoke with a health professional that works with the home and 2 social care professionals.

We reviewed a range of records. This included 6 people’s care records and multiple medicines records. We looked at 4 staff files in relation to recruitment and staff supervision and a variety of agency profiles. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 31 March 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

About the service

Queen Elizabeth Care Centre is a residential care home providing personal and nursing care to up to 74 people in one adapted building. The service provides support to people with various physical and mental health needs, this included people living with dementia and learning disabilities. At the time of our inspection there were 39 people using the service.

The home accommodates people over three floors, however, due to the reduction of people moving in since the last inspection people resided only over two floors.

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

Right Support: People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We found concerns with some risk assessments in people’s care plans and it was unclear if staff were always aware of people’s individual risks. However, the management team had started to review all care plans. People received their medicines at correct times. However, there were some inconsistencies with the management of medicines, such as incorrect recording of topical creams and inconsistent counts of homely remedies.

Right Care: We saw improvements to person-centred care and the new permanent staffing team knew people’s individual needs well. Care plans didn’t always contain person-centred detail. Staff were kind to people and we saw staff respected people’s privacy. People didn’t always have access to activities that were in line with their hobbies and preferences.

Right Culture: Since the last inspection improvements had been made to the culture of the home. People, relatives and staff members were more included in meetings and making decisions about their care. There were still inconsistencies of how effective the changes were and how embedded they were to ensure sustainability.

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 21 September 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We also added a condition to their registration, this ensured we could monitor their progress whilst they were in special measures.

At this inspection we found some improvements had been made. However, there were still some concerns which meant the provider remained in breach of regulations. These breaches were in safe care and treatment, good governance, person-centred care and consent. This service has been rated requires improvement or inadequate for the last three consecutive inspections.

This service has been in special measures since 21 September 2022. During this inspection the provider demonstrated that improvements in some areas had been made. The service is no longer rated as inadequate overall or in any of the key questions, therefore this service is no longer in special measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We found no evidence during this inspection that people were at risk of harm from concerns found. Please see the Safe and Well-Led key questions of this full report. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

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.

Enforcement

We have identified breaches in relation to safe care and treatment, consent, person-centred care and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.