Astley Hall Nursing Home

Updated 16 February 2023

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 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

The inspection was carried out by two inspectors, one Specialist Nurse Advisor and an Expert by Experience. 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

Astley Hall Nursing Home 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. Astley Hall Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before 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 the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do 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 used the service about their experience of the care provided. We spoke with 15 members of staff including the registered manager, quality and compliance manger, operations manager, deputy manager, nurses, team leaders, care staff, the chef, the activities co-ordinator, the administrator and agency care staff. 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. We spoke with the nominated individual after the site visit. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records in relation to people's care, including medication records. We also reviewed a range of records held by the service including, staff training and rotas, recruitment records, audits and checks.

Updated 16 February 2023

About the service

Astley Hall Nursing Home is a care home with nursing, providing personal care to older people, who may have a physical and or sensory impairment, dementia or mental health. At the time of the inspection 22 people were living at the home. The service can support up to 48 people. Astley Hall Nursing Home accommodates people in one adapted building across three floors. The ground floor, Baldwin, supported people with nursing care needs, while the middle floor, Nightingales, provided care and support to people with dementia.

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

Improvements were needed around some aspects of infection control practices to reduce the risk of cross infection. Chairs were seen to be visibly dirty and stained. The physical environment was not decorated or adapted to a consistent standard to meet the needs of people with a sensory impairment or for people who have dementia. Gardens and other outdoor spaces were inaccessible for people to use independently.

People told us they felt safe and supported by the staff who worked in the home. Staff recognised different types of abuse and how to report it. The registered manager understood their safeguarding responsibilities and how to protect people from abuse. People’s care had been planned and potential risks to people had been identified, with mitigation in place to protect people from harm. There were enough staff on duty to keep people safe and meet their needs. People's medicines were managed and stored in a safe way. Recruitment processes were robust to ensure safe employment of new staff.

People's care needs had been assessed and planned, and any changes to people’s planned care was identified promptly. Staff received training and support to be able to care for people in line with best practice. People were supported to have a healthy balanced diet and enjoyed a varied choice of home cooked food. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice. 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 by staff who treated them well. One person said, “On the whole they are very good.” Staff treated people as individuals and respected the decisions they made. Staff treated people with respect and maintained their dignity.

People's care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported to engage in activities and interests which were individual to them. People had access to information about how to raise a complaint. People's end of life care needs were met in line with their preferences in a respectful and dignified way.

The registered manager was visible within the home and listened to people and staff's views about the way the service was run. The provider had strengthened the systems and processes to monitor the quality of the service provision.

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 inadequate (published 05 August 2022) and there were 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.

This service has been in Special Measures since 06 July 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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.

Recommendations

We have made a recommendation about adaptations to the home to promote accessibility and independence.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.