Alban House Residential Care Home

Updated 24 February 2022

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.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 11 February 2022 and was unannounced.

Updated 24 February 2022

About the service

Alban House Residential Care Home is a 'care home'. The home is registered to accommodate up to 23 people in one adapted building. At the time of this inspection there were 17 people living there. The home cared for older people, including people with dementia, learning disabilities and other mental health needs. The home also cared for younger adults with physical disabilities, including neurological conditions such as Multiple Sclerosis.

Alban House has been adapted from three adjoining Victorian terraced houses. There are four floors accessed by a shaft lift.

People’s experience of using this service and what we found

People’s individual risks had been identified and risk assessment reviews had been carried out to identify ways to keep people safe. For example, risk assessments for pressure area care, constipation and those risks associated with specific physical health conditions, such as Multiple Sclerosis and Parkinson’s disease. The service recognised that further work was needed to individual risk assessments and this formed part of the service’ improvement plan. The plan stated: ‘Latest audit shows that some bespoke risk assessments are outstanding.'

The service had implemented an ‘escalation steps’ procedure surrounding the health of individuals, in order for changing needs to be addressed in a timely manner. This involved updating care plans, risk assessments and seeking health and social care professional involvement to address people’s individual needs.

Health and safety failings and areas of the home in need of repair had now been addressed. All relevant health and safety checks were now scheduled in an annual diary. This clearly indicated who was responsible for all checks, including external contractors, visiting for instance to service moving and handling equipment. These checks were being completed in a timely way.

People were protected because the organisation took safety seriously and had appropriate procedures in place. Comments included: “The staff look after me very well” and “I am very comfortable.”

Care plans had been reviewed and clearly detailed people’s individual needs, wishes, goals and how to support them to ensure all individual health conditions and preferences were addressed. Sections specific to people’s physical health conditions were now detailed and explained how certain physical health needs affected people’s lives. For example, for people living with Multiple Sclerosis or Parkinson’s disease. Further work was underway to ensure care plans provided enough information to ensure staff delivered consistent care and support. The service’ improvement plan cited that further work was needed to care plans and this work was on-going.

Improvements had been made to the induction process for new employees. Staff training on essential topics had improved, which enabled staff to feel confident in meeting people’s needs and recognising changes in people’s health. A staff member commented: “100% improved. We have had lots of training we are interested in so we can look after people properly. I am looking forward to doing end of life care training soon.” Staff were now receiving on-going supervision in order for them to feel supported in their roles and to identify any future professional development opportunities.

The staff team had stabilised and felt well supported by the management team and felt able to raise concerns.

A redecoration programme was in place and was being worked through to improve the home’s environment, ensuring it was comfortable for people living there.

Before people received any care and treatment they were asked for their consent and staff acted in accordance with their wishes. People's legal rights were protected because staff knew how to support people if they did not have the mental capacity to make decisions for themselves. People’s capacity to make decisions about their care and support was assessed on an on-going basis in line with the Mental Capacity Act 2005.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Systems to monitor the service had improved to ensure people received a safe service according to their individual needs. Quality monitoring systems were increasingly becoming more effective to provide clear oversight of the service to ensure it was safe for people and reduce risks to their health and well-being. These systems needed to be fully embedded in practice.

The service was being supported by the local authority Quality Assurance Improvement Team (QAIT) to ensure robust systems were in place to ensure people received the appropriate person-centred care and support.

Medicines were safely managed on people’s behalf. There were safe staff recruitment and selection processes in place. Staffing arrangements met people’s needs. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

We continue to receive statutory notifications in relation to safeguarding events and serious injuries in a timely manner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 15 January 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also followed up on further breaches of regulations 11 (Need for consent); 12 (Safe care and treatment); 15 (Premises and equipment) and 18 (Staffing). This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contains those requirements. The overall rating for the service has not changed following this focused inspection and remains requires improvement.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alban House Residential Care Home on our website at www.cqc.org.uk.

Follow up

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.