About the service:

St Elizabeth is a residential care home that was providing personal care to 14 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

¿ We identified breaches in five regulations where the provider was failing to meet the fundamental standards people who use service have a right to expect.

¿ People’s risks were not always fully assessed, and management plans were not always detailed or up to date to ensure people were safe from the risk of avoidable harm. Medicines were not always managed safely and infection control procedures were not always followed.

¿ Staffing levels were not always high enough to keep people safe and to spend time on meaningful activity.

¿ People’s capacity to consent was not always assessed for relevant decisions about their care. People were subject to continuous supervision and were not free to leave as they wished, where people lacked capacity to consent to this arrangement, relevant authorisation had not been sought.

¿ People did not always receive personalised care that met their needs. Suitable adaptations had not been made to the premises to meet people’s needs relating to dementia, which affected their independence. People did not always have activities which met their needs and enabled them to engage. People’s personal history and current condition was not considered when planning activities which affected people’s quality of life.

¿ Quality assurance processes were not robust enough to ensure issues were highlighted and acted upon in a timely manner to prevent people being at risk of harm or poor-quality care.

¿ We have made recommendations relating to reviewing and implementing current guidelines and best practice and reviewing staff training to ensure this give staff required skills to meet people’s changing needs.

Rating at last inspection:

This is the first inspection since the service registered with a new provider on 28 March 2018.

Why we inspected:

This was a planned inspection which was due within 12 months of the service registering with CQC.

Enforcement:

For actions we told provider to take, please refer to the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

Until the provider can show they are compliant with the fundamental standards in the regulations, we will continue to monitor the provider's progress in line with services rated requires improvement. These procedures will include proportionate enforcement action, requesting an

agreed improvement plan with timescales, and meeting with the provider to monitor progress.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk