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Alston View Nursing and Residential Home Requires improvement

We have edited the inspection report for Alston View Nursing and Residential Home from 3 May 2019 in order to remove some text which should not have been included in this report. This has not affected the rating given to this service.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 3 May 2019

About the service:

Alston View Nursing and Residential Home is a care home that accommodates up to 49 older adults, some who may be living with dementia or mental health needs and require nursing care. At the time of the visit there were 45 people who lived there.

People’s experiences of using this service

People told us that they received safe care and treatment. People and their relatives spoke positively about the care and support provided. However, our findings showed improvements were required to ensure the care delivered was consistently safe, reliable and person-centred.

In the majority of cases people’s needs had been assessed and planned for and people’s outcomes had been identified. However, we found shortfalls in the care records and risk assessment for people who had been admitted for a short term stay or as part of a hospital discharge plan. Risk assessments had not been adequately completed and reviewed. The registered manager took immediate action to address this.

The registered manager and the registered provider had ensured the premises were maintained and any faults rectified. They had also completed audits to monitor the safety and quality of care provided.

Staff showed a good understanding of their roles and responsibilities for keeping people safe from harm. However, individual risks to people and the environment had not been adequately monitored to ensure measures were put in place to manage them and minimise the risk of avoidable harm occurring. Risks associated with falls and malnutrition had been managed. However, post falls observations had not been carried out. The infection prevention and control practices in the home needed to be improved.

Governance arrangements were in place to check, monitor and improve the care delivered. However, we found the audits and quality checks had not been adequately implemented to support the registered manager and the provider in identifying shortfalls.

While people’s medicines were safely managed, improvements were required to the safe storage and management of topical medicines such as creams.

Staff had received a range of training and support to enable them to carry out their role safely. However, staff training had not been consistently monitored. There were shortfalls in the provision supervision, appraisals and competence checks to staff.

Consent records were completed, and people told us they were always offered choice and control over the care they received. However, authorisations for restrictions on people’s liberties had not been considered or applied for where required. The registered manager took action after our inspection.

While staff showed a motivation to deliver care in a person-centred way, we found some practices in the home did which did not consistently support a dignified and person-centred approach. This was because people’s preferences for getting up and washing and dressing in the morning were not always followed.

People received support to maintain good nutrition and hydration and their healthcare needs were understood and met.

People and family members knew how to make a complaint and they were confident about complaining should they need to. They were confident that their complaint would be listened to and acted upon quickly.

The leadership of the service promoted a positive culture within the staff team. People, family members and staff all described the registered manager as supportive and approachable. The registered manager showed they were committed to improving the service and displayed knowledge and understanding around the importance of working closely with other agencies and healthcare professionals where needed.

Rating at last inspection: At the last inspection the service was rated good (published 22 July 2016).

Why we inspected: This was a routine planned comprehensive inspection.

Enforcement: We identified four breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around the m

Inspection areas

Safe

Requires improvement

Updated 3 May 2019

This service dropped to requires improvement

Details are in our Safe findings below.

Effective

Requires improvement

Updated 3 May 2019

This service dropped to requires improvement

Details are in our Effective findings below.

Caring

Requires improvement

Updated 3 May 2019

The service dropped to requires improvement

Details are in our Caring findings below.

Responsive

Requires improvement

Updated 3 May 2019

This service dropped to requires improvement

Details are in our Responsive findings below.

Well-led

Requires improvement

Updated 3 May 2019

This service dropped to requires improvement

Details are in our Well-led findings below.