We carried out a review of the data available to us about Elizabethlodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Elizabethlodge, you can give feedback on this service.
Elizabeth Lodge is a residential care home providing accommodation and personal care to 16 older people at the time of the inspection. The service can support up to 18 people.
People’s experience of using this service and what we found
The care people received was safe. The service had systems and processes in place for safeguarding people and managing incidents and accidents. Medicines management was safe and followed good practice guidance. Staff numbers and deployment promoted safe care.
The home followed appropriate recruitment practices and ensured staff were properly checked before they began working at the home. Accident and incidents were reported, recorded and analysed with lessons learnt shared with staff to prevent reoccurrences.
Staff were kind, understanding, and compassionate. People had good relationships with staff. People were supported by staff who knew people's personal and individual needs well. Care was personalised with people's communication needs being met.
Staff were enthusiastic and happy in their work. They felt supported within their roles. Staff described working together as a team, they provided person-centred care and helped people to achieve their potential.
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.
Management had kept in touch with local health protection agencies and kept up to date with government guidance on COVID-19. Updated guidance had been cascaded to staff when needed. People, relatives and staff had received communications throughout COVID-19 on changes and guidance for visiting, PPE and testing. Staff were testing regularly for COVID-19 as per the government guidance.
The service was well-led. Leaders were visible and accessible. There was a culture of openness, inclusion and person-centred care practises. There were systems in place to monitor the quality of care people received. The provider acted on their findings to improve the quality of care.
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 November 2019) and there were breaches of regulation. 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
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and Well-led which contained those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elizabeth lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Elizabeth Lodge is a residential care home providing accommodation and personal care to 16 older people at the time of the inspection. The service can support up to 18 people.
People’s experience of using this service and what we found
People received a service which was not always safe, effective or well-led.
The provider did not have a robust procedure in place to ensure all new staff were safe to work in the home. People were asked for their consent for everyday care and support but there was not a system in place to ensure best interests decisions were made regarding an alarm system in the bedrooms. The registered manager had a system of audits in place to monitor the quality of the care provided. However, the auditing process did not identify the issues we identified during the inspection.
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; however, one policy in the home did not support this practice.
The provider had policies and procedures in place designed to protect people from the risk of suffering harm and abuse. People had assessments in place which identified risks to their health and action was taken to minimise the risks. People received their medicines as prescribed. The provider had processes in place to reduce the risk of the spread of infection.
People’s needs were assessed before moving into the home, so the registered manager could be assured their needs could be met. People’s needs were met by suitable numbers of staff. People were supported by staff who were trained and supported through the use of supervision and annual appraisal.
People felt cared for, were treated well and their privacy and dignity was respected. People were supported to eat and drink enough and had a choice of meals. People could choose where they ate their meals. People were supported to access healthcare professionals when necessary.
People and their relatives, when appropriate, were involved in planning their care. Individual care plans were in place for each person which covered their care, support and communication needs. The activities co-ordinator undertook group activities but also spent time with people in their rooms if they chose to stay there. People’s end of life preferences and choices had been discussed with people and recorded in their care plans.
The registered manager had not received any complaints about the service. Staff and the registered manager liaised with other agencies to ensure consistency of care. The provider and registered manager promoted a positive culture. The registered manager was aware of the duty of candour. The registered manager had formed working relationships with health and social care professionals. Regular testing and maintenance had been completed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 3 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We found evidence that the provider needed to make improvements. Please see the safe, effective 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.
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 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.
Elizabeth Lodge is a care home that does not provide nursing. It provides support for up to 18 older people, some of whom are living with dementia. At the time of our inspection there were 16 people living at the home.
A registered manager was in place. 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.
Medicine records were not always kept appropriately.
People’s care had been appropriately assessed and plans had been developed to ensure that staff met people’s needs consistently and reduced and identified risks.
People confirmed they felt safe and that staff involved them in making decisions and staff knew people well.
Observation demonstrated people’s consent was sought before staff provided care.
People described staff as lovely and caring. Staff treated people with respect and recognised the importance of promoting independence, dignity and privacy.
Staff demonstrated a good understanding of safeguarding people at risk. They were confident any concerns raised would be acted upon by management and knew what action to take if they were not.
Thorough recruitment checks were carried out and the provider ensured there were enough staff on duty to meet people’s needs. Staff received an induction when they first started work which helped them to understand their roles and responsibilities. They felt supported through supervision and training.
People and their relatives knew how to make a complaint and these were managed in line with the provider’s policy. Systems were in place to gather people’s views and assess and monitor the quality of the service.
This is a summary of what people told us and what we found.
Is the service safe?
We observed that people were happy and comfortable in the home. A visitor told us they found everybody to be happy and friendly. There were risk assessments and action plans in place to protect people's safety and welfare.
The premises were maintained and decorated to provide a safe and pleasant environment. Appropriate processes were in place to ensure the environment was kept clean and hygienic. People were protected against risks of infection and the spread of infection.
The manager was aware of the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS were in place for two people using the service at the time of our visit. The service was applying for DoLS for other people who were judged to be a risk of being deprived of their liberty.
Is the service effective?
Staff were supported to deliver effective care. They received appropriate training and support by means of regular supervision and appraisal.
We found people's care and support were based on thorough assessments and detailed and personalised support plans. Systems were in place to ensure care was delivered according to people's plans.
Is the service caring?
We observed positive interactions between staff and people who used the service. Staff we spoke with were motivated and committed to providing high quality support in a caring environment.
One care worker we spoke with described how a person who used the service had been admitted to hospital. They and a colleague had visited and stayed with the person in their own time. The manager confirmed to us that this had happened.
Is the service responsive?
The service had a complaints procedure but received few if any complaints or suggestions to improve the service.
People's care plans and assessments were reviewed regularly and amended if required. The service responded to changes in people's conditions or behaviours and amended their care and support plans as required.
Is the service well-led?
Staff told us they were supported to deliver high quality care and spoke highly of the manager. They were confident any problems would be dealt with properly if they were to arise.
There was a combination of formal and informal systems in place to assess and monitor the quality of the service. Risks were assessed and appropriate action plans were in place. There were processes in place to review and learn from incidents, accidents and complaints.
Staff we spoke with explained how the care and medicine administration were monitored and how issues and concerns were identified and action taken.
We carried out an inspection in July 2013 when we identified concerns with medicines and their administration. We made a compliance action asking the provider to take action in order that we were reassured that people were in receipt of safe and adequate care. The provider wrote to us and told us what action they were going to take and that they would be compliant by the end of August 2013.
We inspected on 1 November 2013 to review the progress the provider had made. We found that the provider had taken steps to improve medicines administration.
We saw that people had their privacy and dignity maintained whilst being supported with care. Care needs had been assessed with a personalised care plan devised with guidance for staff on how to support people.
The home was clean and well maintained. People had personalised their rooms with their own possessions including their own furniture. There were risk assessments for all equipment used to support people.
Staff we spoke with explained how the care and medicine administration were monitored and how issues and concerns were identified and action taken.
We carried out an inspection on 15 April 2013 to review the progress the provider had made in taking action to be compliant in the area where we had previously assessed them as non compliant.
Staff we spoke with explained how the provision of care for example care plans medicine administration were monitored and how issues and concerns were discussed with people who use the service, their representatives and staff.
As not everyone who lived at Elizabeth Lodge was able to tell us what they thought about the care and support provided, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We spent time in their company in the lounge / dining area observing the support people received before and during their meal. We saw that the staff were friendly and respectful and that they were quick to respond if anyone appeared unhappy or distressed or required support. We observed people receiving assistance and support in a timely manner and people were spoken to in a respectful manner.
Staff told us that they liked working at the home and felt involved and had a say in how they provided care. They told us that they had regular training and that some staff for example senior carers had additional responsibilities such as the ordering and receipt of medicines.