28 April 2021
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.
The inspection was carried out by two inspectors and an assistant inspector.
Service and service type
Apsley House 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 the service 24 hours’ notice of the inspection. This was because of the COVID-19 pandemic. We wanted to check if anyone was displaying any symptoms of the virus and to be aware of the provider's infection control procedures.
What we did before inspection
We reviewed information we had received about the service since the last inspection under the former provider. 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 prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service about their experience of the care provided. We spoke with nine members of staff including the registered manager, deputy manager, nurses, care workers, chef, housekeeper, activity coordinator and administration 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 reviewed a range of records. This included four 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 reviewed.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. We spoke with four staff and four relatives on the telephone. We followed up with professionals regarding the safeguarding concerns raised.
28 April 2021
About the service
Apsley House Care Home is a residential care home providing personal and nursing care to 20 people at the time of the inspection. The service can support up to 35 people. Apsley House Care Home is a large converted period property located in Bognor Regis, West Sussex.
People’s experience of using this service and what we found
People spoke highly of the care they received. They told us they were involved in their care and had freedom in how they spent their time at the home. Relatives were equally complementary. One relative told us, “I just can't praise the home highly enough, we are lucky to have found it.” Another said, “They have been brilliant. I can't really give you anything other than incredibly positive feedback about the place.”
People felt safe and told us they enjoyed living at the service. There was a calm and happy atmosphere when we visited. Care staff were well informed about risks to people's health or wellbeing and knew how to deliver care safely. Staffing levels were enough to meet people's needs. Medicines were managed safely. Lessons were learned if things went wrong.
The home was clean and staff had been trained in infection prevention and control. There were clear measures in place to manage the risk of the COVID-19 pandemic. We signposted the registered manager to guidance on personal protective equipment (PPE) for staff unable to wear face masks and to guidance on restricting staff movement between care homes. One staff member told us, “We’ve all pulled together, and I feel safer in here than I do in the outside world.”
People received good quality care that improved their wellbeing. People spoke positively about the staff who supported them and had confidence in their skills and experience. Staff felt supported and were assured their views and opinions were valued. People spoke enthusiastically about the food and were able to make suggestions for additions to the menu. Snacks and drinks were readily available throughout the day. People had access to a range of healthcare professionals and support. Premises were suitable, comfortable and met people's needs.
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.
Strong relationships were formed between staff and people due to the continuity and
caring approach of staff members. People were encouraged to be involved in decisions relating to their care and were treated with dignity and respect.
Staff were skilled in supporting people at the end of their lives. They took time to understand the person’s wishes and worked to facilitate these. Relatives spoke highly of the care their loved ones had received.
People's communication needs were identified and planned for. People expressed confidence they could raise any issues or concerns with any member of staff or the management team and these would be addressed.
The management team had clear systems in place to monitor the care people received and to drive improvement.
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 the service under the previous provider was good, published on 16 August 2019.
Why we inspected
The inspection was prompted in part due to safeguarding concerns. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns.
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.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.