Archived: Lady Elizabeth House

Updated 4 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 23 and 24 October 2018. It was an announced visit to the service. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that managers and staff would be available to assist with the inspection.

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. They were present for the first day only.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed notifications and any other information we had received since the last inspection. A notification is information about important events which the service is required to send us by law.

We contacted community professionals, for example local authority commissioners of the service, to seek their views about people’s care. We spoke with seven people who used the service and one relative.

We spoke with the registered manager, the deputy manager, a senior support worker and a support worker. We spoke with a human resources manager by telephone and had email correspondence with the interim director of the service (who line-manages Lady Elizabeth House). We attended a handover meeting between staff from a morning to an afternoon shift.

We checked some of the required records. These included four people’s care plans, seven people’s medicines records, four staff recruitment files and four staff training and development files. Other records included complaints and compliments, staffing rotas, quality assurance documents, minutes of staff meetings, minutes of tenants’ meetings, accident and incident reports.

Updated 4 December 2018

This inspection took place on 23 and 24 October 2018. It was an announced visit to the service.

Lady Elizabeth House provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented from a housing association and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. Nineteen people were being supported by this service at the time of our inspection. People varied in age from younger adults to older persons and had a range of personal care needs and levels of independence. Each person had their own self-contained flat. There was a communal lounge and dining room people could use and an on-site day service run by the provider. Some people received personal care from other agencies as well as staff at Lady Elizabeth House.

We previously inspected the service in August 2017. The service was rated ‘requires improvement’ at that time. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘effective’ and ‘well-led’ to at least ‘good’. On this occasion, we found improvements had been made to people’s care. These included notification to us of incidents of abuse, assessment of people’s mental capacity and recording when medicines for occasional use had been offered to people. A deputy manager position had been introduced at the service and feedback showed this arrangement was working well.

The service had a registered manager 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.

We received positive feedback about people’s care. Comments included “Without any sort of a lie I can say the care is actually excellent,” “The carers are exceptional” and “They are very friendly to (us). They laugh and joke and look really happy.”

Staff received the support they needed to meet people’s needs, through supervision, training and a structured induction. Appraisals also took place to assess staff performance. Thorough recruitment procedures were used.

Each person had a care plan which outlined the support they required. These had been kept up to date and were accompanied by risk assessments, to minimise the likelihood of injury or harm. Staff supported people with their medicines and nutritional needs, where this was part of their care package.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Quality of care was monitored by the provider through visits to the service, audits and surveys. People were asked for their views in tenants’ meetings and during quality reviews. Complaints were responded to and actions were taken to make improvements, where necessary. The service worked well with other agencies and departments to make sure people received effective and continuous care. This included the housing association and other care providers.