31 March 2022
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. 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.
Two inspectors carried out the inspection. An Expert by Experience made telephone calls to people’s relatives to get their views on the home. 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
The Aldbury is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Aldbury is a care home with nursing care. 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
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 11 people who use the service and seven relatives about their experience of care provided. We spoke with 10 members of staff including the registered manager, operations manager, clinical lead, nurses, care assistants, the chef, facilities manager, senior administrator and domestic staff.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at four 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 looked at reviewed.
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.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We reviewed further documents supplied on request by the registered manager. These included surveys and training data. We spoke with two health professionals who visit the home.
31 March 2022
About the service
The Aldbury is a nursing and care home for up to 55 older people, some of whom may be living with dementia or have nursing needs. The home is purpose built and is divided into four separate living units. There were 37 people living or staying at the home at the time of the inspection.
People’s experience of using this service and what we found
Policies and procedures for safe wound management had been improved since the last inspection. People’s daily records clearly detailed their support needs had been met.
Since the last inspection governance and management systems had been improved. This provided better oversight and helped ensure the delivery of safe and good quality care. There was robust communication throughout all departments.
People felt safe and enjoyed living at The Aldbury. Their relatives expressed confidence in how safe their family members were at the home. Policies and procedures followed by people who used the service, supported current government guidance and helped prevent the spread of infections such as COVID-19.
There were enough suitably trained staff, of good character, to meet people’s needs. Where appropriate, staff referred people to other agencies and health professionals to enable effective outcomes for them.
People and their relatives were involved in decisions about their care. 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.
People, relatives and health professionals felt the home was well managed. They were unanimously positive in the competence and supportive approach of the registered manager. Staff enjoyed working at the home and felt supported by their colleagues. Management provided staff with the opportunity to develop their practice skills and obtain higher qualifications.
The home recognised its contribution to the health and social care system and had supported student nurse placements and training sessions with a local network of GP surgeries.
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 3 June 2020) and there was a breach 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.
At our last inspection we recommended that the service reviewed procedures to ensure that it was working in accordance with the Mental Capacity Act and the associated Code of Practice. We also recommended that the service reviewed governance and management systems to ensure all areas of quality and safety were effectively managed and timely action was taken to address shortfalls when these occur. At this inspection we found the provider had acted on our recommendations and they had made improvements.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Aldbury on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.