Background to this inspection
Updated
1 December 2020
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 coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice are safe and the service is compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.
This inspection took place on 10 November 2020 and was announced.
Updated
1 December 2020
About the service
Autumn House Nursing Home is a care home that provides accommodation and nursing care for adults with a range of care and support needs, including adults who are living with dementia. The home can accommodate up to 41 people in one adapted building over two floors. At the time of this inspection there were 29 people using the service.
People’s experience of using this service and what we found
People told us they felt safe living at Autumn House Nursing Home, however, we found improvements were needed to ensure people were protected from avoidable harm. Medicine management procedures were not always followed, which meant some people’s medicines were not managed safely. People were not effectively protected from the risk of infection. Risks to people were assessed, however, some risk management information was missing from people’s care records. There were enough staff available to meet people’s needs but staff were not always deployed effectively. Staff left some people without the support they needed at mealtimes.
When staff interacted with people we found they were kind, caring and compassionate towards people. It was clear staff knew people well and we observed appropriate laughing and joking between people and staff. However, staff became task focussed during the lunchtime service and they stopped interacting with people and responding to their needs.
The premises required further adaptations to ensure they met the needs of people living with dementia. Some areas of the building were not well-maintained and this made it difficult for staff to keep these areas clean.
People were supported by staff who had received a range of training to develop their skills and knowledge. People were cared for by staff who understood their responsibilities to safeguard people from abuse. Staff supported people to access other community health professionals; this supported people to maintain their health.
People’s dignity was promoted by staff. Where people could complete tasks for themselves, staff encouraged them to do so, to promote their independence. 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 were supported to take part in a range of activities to keep them occupied and entertained. Staff told us they thought people would benefit if staff had more time to support people to remain meaningfully occupied, particularly in the mornings.
The home had experienced several changes in management since the last inspection and this had caused some instability in the service. However, we received very positive feedback about the new manager. The new manager had started working in the home four months prior to this inspection and they had applied to register with CQC. Staff were well-supported by the new manager and they all told us they had seen improvements to the service in the last few months.
Since the last inspection the provider had not implemented enough systems and processes to monitor the safety and quality of the service, to ensure necessary improvements were embedded and sustained. The new manager had created a comprehensive service improvement plan which detailed they steps they would take to ensure the service improved. The manager was responsive to the feedback given during this inspection and acted promptly to start addressing the identified concerns.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 23 January 2018). We identified multiple breaches of regulation at that inspection. There was also an inspection on 7 January 2019, however the report following that inspection was withdrawn as there was an issue with some of the information we gathered.
At this inspection we found the provider was in breach of two regulations. The service remains rated requires improvement. This is the second consecutive time the service has been rated requires improvement.
Why we inspected
This was a planned inspection because of the issue highlighted above.
Enforcement
We have identified breaches of regulation in relation to safe care and treatment and the governance systems used to assess the safety and quality of the service.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.