Allambie Court

Updated 6 April 2022

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 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.

Inspection team

Three inspectors and an Expert by Experience completed this inspection. Two inspectors visited the home and one inspector supported the inspection by making telephone calls to staff. The Expert by Experience supported the inspection by making phone calls to relatives to gain their feedback. 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

Allambie Court 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

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. We used all this information to plan our inspection. 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.

During the inspection

We spoke with three people who used the service and 11 relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, the general manager, two nurses, two senior care workers and three care workers.

We reviewed a range of records. This included three people’s care records and three people’s medication records. We looked at two staff files in relation to recruitment. We reviewed multiple agency staff profiles. A variety of records relating to the management of the service were also reviewed.

After the inspection

We continued to seek clarification from the registered and general manager to validate the evidence found during our inspection.

Updated 6 April 2022

About the service

Allambie Court is a nursing home providing nursing care and accommodation to up to 30 people. There are 26 bedrooms across two floors. Four of these bedrooms can be shared. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 20 people living at the home.

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

Allambie Court has not achieved an overall rating of good for the last six inspections undertaken between March 2016 and January 2022. Effective governance has not been robust enough to drive forward the required improvements.

The provider had not ensured clinical staff had the skills to continuously monitor people's complex nursing conditions. Systems and processes had not identified and mitigated the risks related to people’s health. Action had not always been taken to mitigate and monitor risks related to catheter care and wound management.

Some improvements were required to infection control practices such as asking visitors to wash their hands and the completion of COVID-19 screening questions before visitors entered the home. In addition, the provider was not facilitating visits for people in accordance with current government guidance. They had not consulted with people about the impact a lack of visitors would have on their well-being.

Medicines were stored and administered safely, and people received their medicines as prescribed. Staff were recruited safely and were kind and compassionate towards the people living at the home. There were enough staff to keep people safe. Further training was required to ensure some staff had the skills and competencies to provide high quality care.

The registered manager and general manager were committed to making the required improvements and we received positive feedback from staff and relatives about the leadership of the home. They were responsive to feedback from professionals and had made some improvements following external quality checks.

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

Rating at last inspection

The last rating for this service was requires improvement (published 26 May 2021). The service remains rated requires improvement. This service has been rated requires improvement or inadequate for the last six consecutive inspections.

Why we inspected

We received concerns in relation to staffing and people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 remained requires improvement based on the findings of 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.

We have found evidence that the provider needs to make improvements. Please see the safe 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 Allambie Court 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 monitor the service and will take further action if needed.

We have identified a breach in relation to regulation 9 person centred care and regulation 17 good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.