• Care Home
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Alton Manor Care Home - Portsmouth

Overall: Requires improvement read more about inspection ratings

8-12 Herbert Road, Southsea, Hampshire, PO4 0QA (023) 9286 2904

Provided and run by:
Alton Manor Limited

Latest inspection summary

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Background to this inspection

Updated 26 May 2021

The inspection

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.

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.

Inspection team

Two inspectors carried out the inspection and an additional inspector spoke with staff. An Expert by Experience also supported with this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Alton Manor 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 registered with the Care Quality Commission. This means that they and the provider are 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 because of the Covid-19 pandemic. Inspection activity started on 9 December 2020 and ended on 21 December 2020. We visited Alton Manor Care Home on 15 and 18 December 2020.

What we did before inspection

We reviewed information we had received about the service since the last inspection. 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 of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and eight relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, deputy manager, senior care workers, head of shift, care workers, a cook, a housekeeper, a director and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Overall inspection

Requires improvement

Updated 26 May 2021

About the service

Alton Manor Care Home is a 'care home'. Alton Manor Care Home accommodates up to 34 people living with dementia and physical frailty in one building. At the time of our inspection 30 people were living at the home.

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

Quality assurance systems had not always been effective in identifying the concerns we found at this inspection.

The lack of robust infection control practices placed people at risk of being exposed to infections. This included known risks associated with the current Covid-19 pandemic.

Some risks to people’s safety had not been effectively assessed, monitored or mitigated. The management of medicines was not always safe. No harm had come to people, but we were concerned about the increased risk of harm to people. The provider promptly addressed some of these concerns and had plans in place to address the remaining concerns.

People and relatives provided us with a mixed view about whether there was enough staff to effectively support people. We observed that people were supported in a timely way apart from at lunchtime. The provider told us they would monitor the deployment of staff to ensure people’s needs were met at lunch time.

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 and in their best interests; the policies and systems in the service did not support this practice.

Staff felt well supported through training and supervision. Staff in the service worked well with each other and external professionals to ensure good health outcomes for people

We have recommended that the provider seeks reputable guidance to ensure the requirements of the Accessible Information Standard are consistently met. This was because staff did not always communicate with people in a way they could easily understand.

We mostly observed positive and kind interactions between staff and people, although on some occasions we saw that staff did not engage with people who lived with dementia in the most effective way. Relatives felt staff treated people with dignity and respect and we observed staff respecting people’s right to privacy.

People and relatives told us they were happy overall with the service. Staff enjoyed working at Alton Manor and felt well supported by the registered manager.

The nominated individual, registered manager and director demonstrated a willingness to make improvements and during the inspection began reviewing their systems and process to ensure the service consistently provided good, safe, quality care and support. Further progress was still needed to fully embed and sustain these improvements.

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 01 April 2019). There were four breaches of regulation in relation to regulation 17 Good Governance, regulation 12 Safe Care and Treatment, regulation 11 Consent and regulation 20 Duty of Candour. We met with the provider and they completed an action plan after the last inspection to show what they would do and by when to improve.

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

At this inspection enough improvement had not been made and the provider was still in breach of regulation 11, 12 and 17. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections. We will describe what we will do about the repeat requires improvement in the follow up section below.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Safe, Effective, Caring and Well-led Key Questions which contain those requirements. 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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective, Caring and Well led sections of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to consent, safe care and treatment and governance.

Follow up

We have imposed a condition on the providers registration which requires them to submit a monthly report to the Care Quality Commission on the actions being taken to ensure improvements are being made to quality and safety of the service.

We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.