Annual service review
Name of Service:
Queen Elizabeth House
The quality rating for this care home is:
three star excellent service
The rating was made on:
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A quality rating is our assessment of how well a care home, agency or scheme is
meeting the needs of the people who use it. We give a quality rating following a full
review of the service. We call this review a ‘key’ inspection
We do an annual service review when there has been no key inspection of the service in
the last 12 months. It does not involve a visit to the service but is a summary of new
information given to us, or collected by us, since the last key inspection or annual
service review.
Has this annual service review changed our opinion of the service?
No
You should read the last key inspection report for this service to get a full picture of how
well outcomes for the people using the service are being met.
The date by which we will do a key inspection:
Name of inspector:
Date of this annual service review:
Chris Schwarz
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Annual Service Review
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Information about the service
Address of service:
National Society for Epilepsy
Chesham Lane
Chalfont St Peter
Bucks
SL9 0RJ
Telephone number:
01494601300
Fax number:
01494601300
Email address:
[email protected]
Provider web address:
www.epilepsysociety.org.uk
Name of registered provider(s):
The National Society for Epilepsy
Conditions of registration:
Category(ies) :
Number of places (if applicable):
Under 65
Over 65
learning disability
20
0
physical disability
20
0
Conditions of registration:
The maximum number of service users who can be accommodated is: 20
The registered person may provide the following category/ies of service only: Care
home with nursing (N) to service users of the following gender: Either whose primary
care needs on admission to the home are within the following categories: Learning
disability (LD) Physical disability (PD)
Have there been any changes in the ownership, management or the Yes
service’s registration details in the last 12 months?
If yes, what have they been:
Date of last key inspection:
The service has increased to provide
accommodation to 20 people.
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Date of last annual service review (if
applicable):
Brief description of the service
Queen Elizabeth House is a purpose built service providing care for people who have
epilepsy and physical or learning disabilities. It is one of a number of services on one
site at Chalfont St Peter and is managed by the National Society for Epilepsy. There
are 20 single en-suite rooms which have been designed to meet the needs of people
with disabilities. There are lounges and dining rooms and people can use the facilities
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of the site, which include a therapy service and small shop. The village of Chalfont St
Peter is a bus or taxi ride away as are the nearest shopping centres. The service is
staffed by qualified nurses and carers and people living there have the support of a
multi disciplinary team including specialist consultant neurologists, psychologists and
other therapists. Information about the service can be obtained by visiting or
telephoning.
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Service update since the last key inspection or annual service review:
What did we do for this annual service review?
We looked at all the information that we have received, or asked for, since the last key
inspection which took place on 13 October 2008. This included:
1. The annual quality assurance assessment (AQAA) that was sent to us by the service.
The AQAA is a self-assessment that focuses on how well outcomes are being met for
people using the service. It also gave us some numerical information about the service.
2. Surveys returned to us by people using the service and from other people with an
interest in the service. Four surveys were returned from people using the service and
two from social and health care professionals.
3. Information we have about how the service has managed any complaints.
4. What the service has told us about things that have happened in the service, these
are called 'notifications' and it is a legal requirement for the service to tell us about
them.
5. The previous key inspection and the results of any other visits that we have made to
the service in the last 12 months.
6. Relevant information from other organisations.
7. What other people have told us about the service.
What has this told us about the service?
The Annual Quality Assurance Assessment was returned in good time to carry out this
assessment of the service and had been completed to a high standard. It showed that
views are sought from people using the service through forums such as an annual
survey, residents' meetings and regular reviews of people's placements.
The manager informed us that improvements had been made after listening to service
users such as introducing flexible mealtimes and that a communication workshop took
place to improve communication between relatives and staff. Work has taken place to
improve staff levels of empathy toward people with complex communication needs and
learning disabilities and a video has been produced of service users from the site
sharing their experiences, which new staff are now required to watch.
The service has increased its number of registered places from twelve to twenty this
year after a new extension was completed. At the time the Annual Quality Assurance
Assessment was competed (June 2009) there had been one new admission. The
manager said the needs of existing service users had been taken into account and
some have moved into the new rooms to better meet their care needs. We were
advised that the service continues to have a statement of purpose and service users'
guide in place and these are accessible to users and visitors in the entrance hall and
kept updated. The manager described a thorough pre-admission assessment process
that included prospective users being invited to visit and a series of assessments to
ascertain care requirements.
Information provided in the Annual Quality Assurance Assessment showed that care
plans are in place for people using the service and that they are supported to
contribute to these. The plans are kept under regular review and updated as
necessary. People have a named nurse and key worker. One member of staff has
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completed a train the trainer course on person centred planning. The manager said
staff are continuing to develop video care plans and have purchased a computer
system and cameras to progress this work. Communication passports are being
produced to improve people's experiences of going into hospital and to ensure
continuity of care. We were advised that the service users' computer has been
upgraded to 'have a variety of switches, programmes and internet access in order to
be accessible to all'. We were advised in the Annual Quality Assurance Assessment that
the service has been looking at consent and capacity issues and that deprivation of
liberty issues have been looked at for all of the people using the service.
The manager advised that people using the service are supported to engage in
meaningful activities and that there are links with local colleges, an onsite therapy
department and a learning and skills department. We were advised that each person
has a personalised activity plan and a personal development record, which are kept
under review. Off site activities also take place and this has been improved through
acquiring a driver and more staff being able to use the National Society for Epilepsy's
transport. The manager advised us that menus are kept under review and that a
dietician regularly supports the service. Improvements have been made such as
producing enhanced menus through use of photographs and recipes for each menu,
acquiring a fridge specifically for defrosting meat and a new style of training on food
handling which involved people using the service and staff.
Information provided in the Annual Quality Assurance Assessment reflected continuing
good practice in meeting people's personal and health care needs. Safe behaviour
management training takes place and physical intervention plans are drawn up where
necessary. Care plans outline the support each person requires and people using the
service have access to a range of medical professionals to keep them healthy and well.
Staff handover sessions ensure important information is communicated to staff. Aids
and adaptations are in place to assist with daily living tasks, such as raised toilet seats
and hoists. The design of the building is to a high specification to take into account
needs arising from physical disabilities. Two nurses have completed a nursing course
on advanced practice in epilepsy. The manager has undertaken a train the trainer
course on first aid and one of the senior nurses has agreed to become a safeguarding
trainer. There are plans to train someone to become an infection control trainer.
The manager advised that there are complaints procedures in place at the service and
a pictorial version of this is included in the service users' guide. There are copies of the
procedure displayed in the building. Staff receive training on safeguarding vulnerable
adults and there are plans to deliver training for people using the service. Three
complaints and one safeguarding issue were identified in the statistical information
provided by the manager.
The service is divided into two six bedded and two four bedded units, all with single en
suite bedrooms. All accommodation is on ground level and bedrooms have doors
leading to patio areas. People are encouraged to personalise their rooms and are
consulted about decor and furnishings. The original part of the building has been
improved through redecoration, fitting of some new carpets, some new armchairs have
been purchased and an electric organ has been bought for music sessions. Two games
consoles have been purchased which respond to individual movements. The new part
of the building has a walled garden which is being developed by people using the
service with support from staff. The idea of keeping chickens is being considered.
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The manager described thorough recruitment processes and involvement of service
users in attending job fairs and in interviewing prospective staff members. Induction of
new staff follows the Skills for Care common induction standards and people using the
service are asked to provide feedback on staff performance before they are confirmed
in post. Handovers and staff meetings take place and there are systems for supervising
and appraising staff. The manager advised that there have been difficulties in
recruiting qualified nurses and an experienced senior nurse has transferred from
another part of the site for a six month period to help support the service. The service
is also working with a local university to sponsor six return to work nursing
placements. The service now has an administrator position and the new extension gave
rise to the creation of two team leader positions.
The manager is an experienced and qualified nurse and is registered with the
Commission. Information provided in the Annual Quality Assurance Assessment
reflected a drive to keep improving the service, adherence to good practice and
involving service users, staff and relatives in developing the service. He has completed
a leadership and management programme and keeps up to date with training. The
manager has kept us informed of significant events at the service which affect people's
welfare.
Various audits were described to assess and improve quality of care, such as
medication, health and safety and care plan audits. He advised that changes have been
made to handling service users' money to provide better safeguards. Statistical
information showed that there is good regard for health and safety with regular
servicing of equipment, an action plan and training on best practice on prevention and
control of infection, nutritional screening for all newly admitted people and training in
safe food handling. The manager has also been developing three nurse roles in
infection control, fire safety and health and safety.
People using the service said in surveys that they had been asked if they wanted to
move into the service. They considered they had been given enough information about
it to help decide if it was the right place for them. They said they 'sometimes' make
decisions about what to do each day and can do what they want during the day, in the
evening and at weekends. People using the service said they knew who to speak with if
they were unhappy and how to make a complaint. They said the premises are 'usually'
kept fresh and clean and that staff and managers treat them well and act on what they
say. Two people said the food was good at the service. One person said the service
could improve by repairing things more promptly.
Two surveys were received back from social and health care professionals who work at
The National Society for Epilepsy. They said that the service's assessment
arrangements 'usually' ensured that accurate information is gathered and that the right
service is planned for people. They said people's social and health care needs are
properly monitored, reviewed and met. They said the service 'usually' seeks advice and
acts on it to meet health care needs and improve well being. They considered that
medication was 'usually' appropriately managed and that people's privacy and dignity
were 'usually' respected. They said the service 'usually' supports people to live the life
they choose wherever possible and that staff and managers 'usually' have the right
skills and experience to support people. They considered that people's needs arising
from equality and diversity were 'usually' responded to and that the service responded
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appropriately if they had raised any concerns. One commented 'the service provides
care and support to clients with very complex needs. The manager and his staff are
very indulgent of their clients' needs, often going the extra mile. There is a relaxed,
homely atmosphere and the clients always appear fond of staff and comfortable in their
presence. Staff seem able to cope with the demands of this client group and have
developed real skills in this area.' The person felt the service would benefit by
recruiting staff who have experience in working with people with mental health
problems to add to collective team skills.
The information that has been provided in order to carry out this review indicates that
the service continues to provide a good standard of care to people living at Queen
Elizabeth House and that we do not need to alter our planned inspection schedule.
What are we going to do as a result of this annual service review?
The next key inspection of Queen Elizabeth House will be carried out before 12 October
2011 to review our assessment. However, we can inspect the service at any time if we
have concerns about the quality of the service or the safety of the people using it.
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Reader Information
Document Purpose:
Annual service review
Author:
CQC
Audience:
General Public
Further copies from:
0870 240 7535 (national contact centre)
Our duty to regulate social care services is set out in the Care Standards Act 2000.
The content of which can be found on our website.
Helpline:
Telephone: 03000 616161
Email: [email protected]
Web: www.cqc.org.uk
We want people to be able to access this information. If you would like a copy of the
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Copyright © (2009) Care Quality Commission (CQC). This publication may be
reproduced in whole or in part, free of charge, in any format or medium provided that it
is not used for commercial gain. This consent is subject to the material being
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misleading context. The material should be acknowledged as CQC copyright, with the
title and date of publication of the document specified.
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