Archived: Autumn House Nursing Home

Updated 11 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 October 2015 and was unannounced. This meant the people who lived at Autumn House and the staff who worked there did not know we were coming. The inspection team consisted of two adult social care inspectors and an expert -by -experience. An expert-by-experience is a person who has personal experience of using, or caring for someone who uses this type of care service. The expert had experience of older people and people living with dementia.

Before our inspection, we reviewed the information we held about the home. This included correspondence we had received about the service and notifications submitted by the service. We asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR was returned as requested.

We contacted Barnsley local authority and Barnsley Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We received feedback from Healthwatch, Barnsley local authority commissioners and the local authority safeguarding team. This information was reviewed and used to assist with our inspection.

During the inspection we spoke with 11 people who used the service and six people’s relatives.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. Throughout the inspection we also spent time in the communal areas of the home observing how staff interacted with people and supported them.

We spoke with nine members of staff, which included the registered manager, Registered General Nurse, five care staff, administrator, and ancillary staff such as catering and domestic staff. We also spoke briefly with the registered provider who visited the home during our inspection.

We spent time looking at records, which included three people’s care records, three staff records and other records relating to the management of the home, such as training records and quality assurance audits and reports.

Updated 11 November 2015

Autumn House provides personal and nursing care for up to 41 older people. There is a separate unit to care for people living with dementia.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

Our last inspection at Autumn House took place on 2 September 2013. The home was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 5 October 2015 and was unannounced. This meant the people who lived at Autumn House and the staff who worked there did not know we were coming. On the day of our inspection there were 37 people living at Autumn House.

People and their relatives told us they were safe in the home. Staff had undertaken training in how to respond to safeguarding issues and concerns and were able to describe to us the correct process to follow. We saw where concerns had been raised these had been shared promptly with the local authority safeguarding team.

Risks had been assessed and where possible action had been taken to reduce the likelihood of the risk occurring. Accidents and incidents were monitored to ensure staff responses had been appropriate.

People, their relatives and staff told us there were enough staff to meet people’s needs. We saw staff were able to respond to people’s requests quickly. One relative did raise some concerns about staffing levels at a specific time of the day. The manager said they were addressing this issue and intended to raise staff numbers.

Recruitment processes were in place to ensure checks on candidates’ character were undertaken before staff began working in the home. Checks were in place to check nurses’ qualifications and registration were up to date.

Medicines were managed appropriately.

Staff training was up to date. The registered manager monitored essential training to ensure any refresher courses were booked before training expired. Staff had received a range of training in care and welfare subjects in addition to training specific to the needs of people they supported, such as dementia, end of life and mental capacity training.

Care staff and nurses received regular supervision sessions and a yearly appraisal.

The principles of Mental Capacity Act 2005 (MCA) were followed. People had capacity assessments completed which involved families and care professionals. Independent Mental Capacity Advocates (IMCAS) visited and supported people who did not have families or representatives. These visits were to support and promote people’s best interests. Where decisions had been made on people’s behalf, documentation had been completed to evidence that their capacity had been assessed and that the decision had been made in their ‘best interests’.

Where restrictions were in place to keep people safe, applications had been made to the local authority to grant Deprivation of Liberty Safeguards.

Since our last inspection improvements had been made to the environment for people living with dementia. Other areas of the home had also been refurbished. The home was brighter and better signage and lighting had been provided whilst a homely feel to Autumn House had been maintained.

All of the people we talked with, and their relatives spoke highly of the staff and how well they cared for them. Staff had good relationships with people, they responded with a gentle and kind manner when communicating with people and providing any care or support.

There were mixed views from people regarding the quality of food served in the home. Some people were very positive; others said they were not too “keen” particularly about the vegetables served. A choice of food was available at mealtimes.

During mealtimes staff were attentive and considered people’s individual needs. People were encouraged to be independent by staff. Where people did need help from staff with their meals, this was provided in a dignified way.

People had access to some social activities although some people said the activities were a little repetitive.

We observed people’s needs were met by staff that understood how care should be delivered. We found care records were detailed and reflected the care delivered.

People and relatives’ feedback was encouraged through regular meetings and a yearly survey. Complaints had been investigated and responded to.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.