25 May 2021
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 Care Act 2014.
This focussed inspection was prompted by our internal intelligence systems that assess potential risks at services. It was also completed to check whether the provider had met the requirements of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
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.
The inspection team consisted of one inspector.
Service and service type
Alfriston Court Care Home is a ‘care home’. 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.
The service had a manager, who had applied for their registration with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection. This was because of the COVID-19 pandemic. We needed to know about the provider’s infection control procedures.
What we did before the inspection
We reviewed the information we held about the service and the service provider, including the previous inspection report and the action plan supplied by the provider. We looked at notifications and any safeguarding alerts we had received for this service. We sought feedback from the local authority and professionals who work with the service. Notifications are information about important events the service is required to send us by law.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with four people and other people who used the service throughout the inspection. Due to their dementia, people were not always able to give feedback about their experience at the home. Therefore, we spent time talking with them and observing their interactions with staff. We spoke with five members of staff including the manager.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke to two health professionals who have a knowledge of the service.
25 May 2021
About the service
Alfriston Court Care Home is a nursing home providing personal and nursing care to 27 people aged 65 and over. At the time of the inspection there were 23 people living in one adapted building. People living at the home had a range of needs. Some people were living with dementia whilst some had clinical needs and those associated with old age.
People’s experience of using this service and what we found
We found that improvements had been made following the last inspection.
Quality and governance systems had improved however they had not been fully established and embedded into everyday practice. This meant areas needing improvement were not always identified and responded to effectively. We found some care plans were not complete. This included the absence of suitable care plans to support people with dementia, their mental health and emotional needs. Management and medicine audits had not identified missing and poorly completed records. These areas were identified as needing improvement.
People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. There were enough staff working to provide the support people needed and recruitment practice ensured only suitable staff worked at the service.
There were suitable arrangements in place to assess and respond to any risk to people and to provide people with their prescribed medicines safely. Infection prevention control measures meant the service was clean and people were protected, as far as possible, from the risk of COVID-19.
People received personalised care that was delivered by staff who had a good understanding of their needs and how they should be met.
People had access to health professionals to promote their health. People had regular contact with the activity staff to promote social interaction and minimise any risk of isolation. Visiting was taking place in line with government guidelines. Complaints were listened to and resolved in a timely way.
The new manager had established a positive culture at the service and was supportive to people and staff. They understood their responsibilities and was making positive changes in the service to improve outcomes for people. There was a clear management structure with the manager supported by a clinical lead and a team of registered nurses.
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 Requires Improvement (published 26 July 2019).
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by our internal intelligence systems that assesses potential risks at services, taking account of concerns in relation to aspects of care provision and previous ratings and any enforcement. As a result, we undertook a focused inspection to review the key questions of Safe, Responsive and Well-led only. This enabled us to review any potential risks and review the previous inspection ratings.
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.
During the inspection no areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
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 Alfriston Court Care Home on our website at www.cqc.org.uk.
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.