Background to this inspection
Updated
16 September 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 on day 1 by 2 inspectors 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. On day 2 the inspection was carried out by 1 inspector and a medicines inspector.
Service and service type
Allerton Park Care Centre 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. Allerton Park Care Centre 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. Inspection activity started on 11 July 2023 and ended on 24 July 2023. We visited the service on 11 and 13 July 2023.
What we did before the inspection
We reviewed information we had received about the service, and 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 6 people and 1 relative of people who use the service about their experience of the care provided. We spoke with 10 staff members, including the registered manager, nurse, team leaders, care workers and administration staff. We reviewed 6 people’s care records in full, sampled parts of 4 peoples records and reviewed multiple people’s medication records.
We looked at 3 staff files in relation to recruitment and staff supervision. We also requested a variety of records relating to the management of the service, including policies and procedures and training documents.
During and after the onsite inspection days we requested further documents, such as audits and governance records.
Updated
16 September 2023
About the service
Allerton Park Care Centre is a residential care home providing personal and nursing care for up to a maximum of 50 people. The service provides support to people living with dementia and some who have mental health needs. At the time of the inspection there were 46 people living at the service.
People’s experience of using this service and what we found
People were not always safe. People were at risk of harm as the provider had not identified, assessed, or mitigated risks. These included risks related to people’s health and care needs as well as environmental risks. The environment was tired, not well maintained and appeared unclean. Staff did not always follow safe infection and control practices. Medicines were not managed safely. Some people told us they did not feel safe in the home.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
There was a lack of effective leadership and an ineffective governance structure which meant the service was not appropriately monitored at manager or provider level.
Safe recruitment processes were in place and staffing levels were sufficient with effective deployment in the service. Premises and equipment certificates and servicing were in place and in date.
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 good (published 18 November 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
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 has changed from good to inadequate based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Allerton Park Care Centre on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, management of medicines, consent to care, premises, and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.
Special Measures:
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.' This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.