Archived: Elizabeth House - Gloucester

Updated 11 December 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This was a targeted inspection looking at the infection control and prevention measures the provider has in place. As part of CQC's response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

This inspection took place on 11 November 2020 and was announced. The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.

Updated 11 December 2020

This inspection was completed on 23 and 24 April 2018 and was unannounced.

Elizabeth House is a part of the National Star Foundation Charity and is registered to provide accommodation for up to 25 men and women with a physical disability and/ or learning disability or autistic spectrum disorder. Although a part of the National Star Foundation, Elizabeth is a residential home based at a separate site to the main National Star College Campus. The young people living at Elizabeth House attended the main National Star College campus for their education.

Elizabeth House 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. At the time of our inspection there were 25 people living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The previous comprehensive inspection was completed in May 2015 and the service was rated ‘Good’ overall. At this inspection, the service was rated ‘Outstanding’.

Elizabeth House is an outstanding service. It is focussed on the individual needs of the young people. The service ensured that everyone received high quality care regardless of diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances.

The vision of Elizabeth House and the National Star Foundation was to promote “A world in which people with disabilities are able to realise their potential as equal and active citizens in control of their lives”. All staff and senior management demonstrated this clear vision and a highly positive person centred culture was evident. Staff involved in Elizabeth House had set high standards for themselves and this promoted an exceptionally positive culture for those living there. The provider played a lead role nationally in challenging perceptions of disability which further supported this work. This had improved the confidence of people and the opportunities available to them .

People were supported to focus on making a positive contribution to the service, the college and the wider community in order to achieve their full potential. Young people had been supported to actively campaign to improve rights and entitlements for people with disabilities. We found young people and staff were motivated and passionate about equality and empowering people to live the lives they wanted.

People and relatives we spoke with told us staff were outstandingly caring. They used words such as “Compassionate”, “Caring” and “Excellent” to describe the staff. People and their families spoke of a service that was tailor-made for them and their families said staff went ‘over and above’ what was expected of them. Care staff spoke highly about the service provided. One said, “I’ve been here for 10 years. I love working here”. Another person said, “I really enjoy working here. These people are like family to me”. People told us they would recommend the service to others. There was a genuine sense of fondness and respect between the staff and young people.

People, their families and carers spoke overwhelmingly of the positive support, guidance and healthcare interventions given to them. People were 'very happy' with the service they received and we received many positive comments about their views and experiences. People and their families viewed the staff as exceptionally skilled and knowledgeable when supporting them with complex health needs.

Outstanding systems and processes had been implemented to safeguard people from abuse and harm. These ensured the safety and well-being of the people using the service. People's risks were continually assessed, identified and managed exceptionally well and their care needs were met to a very high standard. The provider encouraged and empowered students and staff to have the confidence to suggest innovative and creative solutions to manage risk. This supported people to live their lives as they chose. Staff promoted a culture of ‘anything was possible’, within a framework of assessing risk, without being risk averse.

Where possible, people were involved in the planning of their care. Where support was needed to do this people's representatives were encouraged to be involved. People's care plans were detailed and personalised which helped staff deliver the support people wanted and needed. Care was particularly personalised and therefore tailored to individual needs and wishes. For a large number of people, this had resulted in improvements to their health, wellbeing and abilities which in turn had meant people had become more independent. People had very good access to health care professionals when required and their medicines were managed well.

People were cared for by staff who knew them really well and who had been exceptionally well trained to support them. . Staff were very well supported and valued by the provider who invested well in their training and welfare. The service had developed very thorough staff training programmes. These were bespoke to the needs of the people living at the service and ensured staff were highly skilled in meeting very specific needs. The training systems developed had received local and national recognition and were used to train staff in other agencies as well as other professionals. There was a strong sense of "family" and team work. Staff were proud of the work they did and were fully committed to ensuring people were at the centre of everything that took place at Elizabeth House.

Staff were constantly looking for ideas on how to improve people's quality of life. Assistive technologies were used creatively and innovative technologies were developed with young people to enhance their communication and independence. This enabled people's aspirations to be explored with them and plans made to achieve these. Staff worked hard to make sure, that where possible, people had opportunities to lead as full a life as possible. They made sure daily activities were tailored to meet people's individual needs, preferences and abilities. Staff made sure people had opportunities to enjoy themselves. People's suggestions and ideas were sought and valued when it came to planning these activities.

The registered manager and extended leadership team offered exceptional leadership and had a clear vision about the direction of the service. They were highly committed to improving people's lives and ensuring people had the best care they could receive. Managers expected the same high standards from the staff who were fully committed to these shared values. The management team were very much part of the overall care team at Elizabeth House. They were very involved in people's care and were visible and approachable. Staff at the service clearly understood their roles and worked hard to promote a homely atmosphere. The provider was involved in various national schemes to promote better care for people. This had led to the development of innovative practice for example in relation to the sourcing of work placements and development of innovative technologies for young people.

There was a robust quality assurance system in place to ensure people received the best possible service. The registered manager worked closely with partner agencies and services to promote best practice within the service and make a positive impact to people’s lives. The service was constantly striving to make improvements in order to ensure they were providing the best possible care and support to the people living at Elizabeth House. The registered manager had developed a strong leadership team which were innovative and proactive. They had plans in place to ensure the high standards implemented were sustained in their absence.