Old Alresford Cottage

Updated 1 September 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 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 undertaken by one inspector 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

Old Alresford Cottage 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. Old Alresford Cottage 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification tells us about important issues and events which have happened at the service. We used all of this information to plan our inspection.

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.

During the inspection

We spoke with seven people living in the home and six relatives/ friends. We also spoke with the registered manager, deputy manager, 2 regional managers, the infection control lead, the activity coordinator and six care workers.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received written feedback from a further four staff, three relatives and two health and social care professionals. We also continued to seek clarification from the provider to validate evidence found.

Updated 1 September 2022

About the service

Old Alresford Cottage provides accommodation and personal care for up to 44 people. The home is an older style building arranged over three floors with rooms accessed by lift or stairlift. The home describes itself as specialising in supporting people living with dementia. There were 35 people using the service when we inspected.

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

Improvements were needed to ensure the premises were kept clean and hygienic throughout and the interior of the home maintained and decorated to an acceptable standard. We received mixed feedback about staffing levels and there was an inconsistent approach to managing some of the risks to people’s health and wellbeing. Staff understood their responsibility to raise concerns and report safety related incidents. People told us they felt safe at Old Alresford Cottage and staff had clear guidance about what they must do if they suspected abuse was taking place.

We made a recommendation about seeking ways in which to make the environment more supportive of people living with dementia, or other sensory deficits.

The governance systems in place were not being fully effective at ensuring the quality and safety of the service. Staff understood the values of the service and spoke of a positive culture and of the importance of providing people with person-centred care. Overall people told us staff were kind, caring and friendly and we observed interactions where staff engaged with people in a cheerful and positive manner. Feedback from relatives and professionals about the registered manager was mostly positive, with a professional praising the registered manager for the hard work and support they and his team had provided with a case that was very challenging at times.

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 31 August 2021) and there were two breaches of Regulations. At this inspection we found that insufficient improvements had been made and the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 24 and 27 May 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do, and by when, to improve the safety of recruitment procedures and the robustness of the governance arrangements.

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 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 remains requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Old Alresford Cottage on our website at www.cqc.org.uk.

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.

Enforcement and Recommendations

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 breaches in relation to safe care and treatment and good governance.

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.