Elizabeth House

Updated 14 December 2022

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.

This was a focussed inspection to check whether the provider had met the requirements of the Requirement Notice in relation to Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and to follow up on concerns we had received about infection prevention and control at the home.

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

The inspection was carried out by an 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.

Service and service type

Elizabeth House 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. Elizabeth House is a care home without 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. However, a new manager was in post and they had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced. Inspection activity started on 7 November 2022 and ended on 14 November 2022. We visited the service on 7 and 8 November 2022.

What we did before the inspection

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 reviewed feedback we had received from the local authority. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 2 relatives about their experience of the care provided. We spoke with the provider, the manager and 3 care assistants.

We reviewed a range of records. This included 3 people’s care records, the medicines records and 2 staff recruitment files. A variety of other records relating to the management of the service were also considered as part of the inspection. These included audits, training and supervision records, health and safety checks and minutes of meetings.

Updated 14 December 2022

About the service

Elizabeth House is a residential care home providing personal care for up to 30 people. At the time of our inspection there were 28 people living at the home. The home is an adapted building set in its own grounds, opposite Alexandra Park and about a mile from Oldham town centre.

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

People’s medicines were not always managed safely. Some people had not received their medicines as prescribed by their doctor. There had been recent concerns about infection prevention and control at the home, with an infestation of mice and poor standard of cleanliness in the kitchen. However, the provider had taken prompt action to rectify the problem and there was ongoing work to improve the standard of decoration within the home.

Staff had completed training in safeguarding and knew how to recognise and report abuse or neglect. The service had a safe recruitment process which ensured only suitable staff were employed. Staff were aware of risks to people's health and wellbeing and knew how to manage them.

Improvements had been made to staff training since our last inspection. Staff were appropriately trained and received supervision and support from the management team. 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 respected people's choices and independence. People's health and wellbeing was monitored and staff sought advice from outside health care professionals when needed. People's dietary needs were met.

There had been a change of ownership and management of the service since our last inspection. People, relatives and staff all spoke positively about changes that were taking place at the service. Audits to monitor standards at the home had been carried out regularly. However, medicines audits had not always been completed correctly which meant missed medicines had not been identified or any remedial action taken.

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 19 February 2021). There was a breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection the provider remained in breach of regulations, and their rating remained requires improvement.

At our last inspection we recommended the provider improve staff training. At this inspection we found this had been completed. However, we found concerns around the management of medicines.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection and to respond to concerns we had received about infection prevention and control.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Recommendations and enforcement

We have identified a breach of regulations in relation to safe care and treatment.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.