Alston View Nursing and Residential Home

Updated 4 July 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 Care Act 2014.

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 first and final day of the inspection was conducted by a single inspector. On the second day, 2 inspectors attended the home.

Service and service type

Alston View Nursing and Residential 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. 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.

Inspection activity started on 25 April 2023 and ended on 3 May 2023.

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, commissioners and professionals who work with the service. We also looked at information we had received and held on our system about the service, this included notifications sent to us by the provider and information passed to us by members of the public.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service. We spoke with 3 relatives about their experience. We spoke with members of staff including the registered manager, deputy manager, a provider director and care workers and a member of the domestic staff. We also spoke with 5 external health and social care professionals and received their feedback of the quality of the service.

We looked at a variety of records to gather information and assess the level of care and support provided to people. We reviewed in detail 5 care records. We looked at staff rotas, risk assessments, multiple medicine records and 5 recruitment files. We also considered a variety of records relating to the management and governance of the service, including policies and procedures.

We looked around the home in both communal and private areas to establish if it met the needs of people who lived there and if it was safe.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found.

Updated 4 July 2023

About the service

Alston View Nursing and Residential Home (Alston View) is a care home providing personal and nursing care and accommodation to older people. At the time of the inspection, 44 people were receiving regulated activities at the home. The service can support up to 50 people. The home is a purpose-built building with two lounge areas and a dining room on the ground floor. Bedrooms are based over two floors.

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

People were exposed to the risk of harm. Risks were not appropriately identified, assessed or managed in a timely way. During the inspection, we identified failings in respect of fire safety arrangements, use of bed-rails, medicines and in the leadership and governance of the service. Poor communication often meant essential safety issues and risks were not appropriately elevated and dealt with effectively.

Some aspects of staff recruitment were not completely effective at ensuring staff members were always suitable to work with vulnerable people. Some essential safety checks had not been made. We have made a recommendation about this that can be seen in the 'safe' section of this report.

Infection, Prevention and Control (IPC) processes were appropriate and we were assured about the service's ability to mitigate the transmission of infections.

Staff were competent with safeguarding processes and knew how to protect people from abuse. Relatives said their loved ones felt safe in the home and were trusting of staff and management. We observed good practices and interactions between staff and people during the inspection. The service's safeguarding processes were robust.

Staff supported people to have access to healthcare professionals and specialist support and the service worked with external specialists. Professional's views on the service were mixed but those who we spoke with at inspection said that the service was improving.

People were confident in the management team at the home and praised how approachable they were. Relatives said their loved ones were safe and praised the friendly and caring attitudes of staff and managers. We noted good interactions between people, management and staff. The service made appropriate notifications to CQC and other authorities of safety incidents to ensure these incidents received appropriate oversight.

The registered provider was responsive to concerns noted during the inspection and has started to take action to make improvements and promote safety within the home.

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.

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 13 July 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

At our last inspection in 2021 we recommended that the provider's programme of improvements should be expanded to cover all areas of care and support to people. At this inspection, we found the provider had not acted on this and the service was now in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service and information provided to us by partner agencies. As a result, we carried out 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.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 'Alston View Nursing and Residential Home' on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches of the regulations in relation to management of risk, administration of medicines and governance at this inspection. We have also made a recommendation around the provider's recruitment processes.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority and fire service to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.