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Aslockton Hall Nursing & Residential Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 April 2018

This inspection took place on 21 and 23 November 2017 and the first day was unannounced.

Aslockton Hall Nursing & Residential Home is a ‘care home with nursing’. 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. Aslockton Hall Nursing & Residential Home accommodates up to 62 people in one adapted building. At the time of our inspection 39 people lived at Aslockton Hall Nursing & Residential Home.

The service is required to have a registered manager. 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. At the time of our inspection visit the manager was not registered but was going through the process to become registered. The manager is now registered.

During our previous inspection on 6 and 7 September 2016 we rated this service as ‘Requires Improvement’ overall. At this inspection, we also rated this service as ‘Requires Improvement’ overall and the well-led question was rated ‘Inadequate’.

We also identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection. You can see the action we have told the provider to take at the back of this report.

Risks were not always managed so that people were protected from avoidable harm.

Sufficient staff were on duty but they were not effectively deployed to meet people’s needs at all times. Some medicines management practices required improvement though people received their medicines as appropriate.

The home was clean but staff did not always follow correct infection control practices. Themes and trends in relation to accidents and incidents were reviewed and investigations of specific incidents were carried out though action taken in response to specific incidents was not always clearly documented and lessons were not always learned.

Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Staff were recruited through safe recruitment practices.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

The premises had not been adapted to ensure that it met people’s needs especially those people living with dementia. People received sufficient to eat and drink but the mealtime experience upstairs required improvement. Staff received appropriate supervision but did not attend dementia training and appraisals were being planned but had not been completed.

People’s needs and choices were assessed and care was delivered in a way that helped to prevent discrimination and was in line with evidence based guidance. People’s healthcare needs were monitored and responded to appropriately.

People were cared for by staff who were pleasant and kind, however, staff were rushed and task orientated. Staff did not always respect people’s privacy and dignity. However, they did promote people’s independence and people’s relatives and friends were able to visit them without any unnecessary restriction.

People were involved in decisions about their care and support and information was available in accessible formats. Advocacy information was made available to people.

Activities required improvement. Care records did not always contain information to support staff to meet people’s individual needs. Processes required improvement for supporting people with end of life care where appropriate.

People were involved in planning their care and support. People were treated equally, without discrimination. The manager had limited knowledge of the Accessible Information Standard, however efforts had been made to ensure people with communication needs and/or sensory impairment received appropriate support. Complaints were handled appropriately.

The provider was not fully meeting their regulatory responsibilities and systems in place to monitor and improve the quality of the service provided were not fully effective.

A clear vision and values for the service were in place. However, we observed that staff did not always act in line with those values.

Staff felt well supported by the manager. People and their relatives were involved or had opportunities to be involved in the development of the service.

Inspection areas

Safe

Requires improvement

Updated 7 April 2018

The service was not consistently safe.

Risks were not always managed so that people were protected from avoidable harm.

Sufficient staff were on duty but they were not effectively deployed to meet people’s needs at all times. Some medicines management practices required improvement though people received their medicines as appropriate.

The home was clean but staff did not always follow correct infection control practices. Themes and trends in relation to accidents and incidents were reviewed and investigations of specific incidents were carried out though action taken in response to specific incidents was not always clearly documented and lessons were not always learned.

Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Staff were recruited through safe recruitment practices.

Effective

Requires improvement

Updated 7 April 2018

The service was not consistently effective.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

The premises had not been adapted to ensure that it met people’s needs especially those people living with dementia. People received sufficient to eat and drink but the mealtime experience upstairs required improvement. Staff received appropriate supervision but did not attend dementia training and appraisals were being planned but had not been completed.

People’s needs and choices were assessed and care was delivered in a way that helped to prevent discrimination and was in line with evidence based guidance. People’s healthcare needs were monitored and responded to appropriately.

Caring

Requires improvement

Updated 7 April 2018

The service was not consistently caring.

People were cared for by staff who were pleasant and kind, however, staff were rushed and task orientated. Staff did not always respect people’s privacy and dignity. However, they did promote people’s independence and people’s relatives and friends were able to visit them without any unnecessary restriction.

People were involved in decisions about their care and support and information was available in accessible formats. Advocacy information was made available to people.

Responsive

Requires improvement

Updated 7 April 2018

The service was not consistently responsive.

Activities required improvement. Care records did not always contain information to support staff to meet people’s individual needs. Processes required improvement for supporting people with end of life care where appropriate.

People were involved in planning their care and support. People were treated equally, without discrimination. The manager had limited knowledge of the Accessible Information Standard, however efforts had been made to ensure people with communication needs and/or sensory impairment received appropriate support. Complaints were handled appropriately.

Well-led

Inadequate

Updated 7 April 2018

The service was not well-led.

The provider was not fully meeting their regulatory responsibilities and systems in place to monitor and improve the quality of the service provided were not fully effective.

A clear vision and values for the service were in place. However, we observed that staff did not always act in line with those values.

Staff felt well supported by the manager. People and their relatives were involved or had opportunities to be involved in the development of the service.