Background to this inspection
Updated
24 July 2021
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
This inspection was carried out by two inspectors.
Service and service type
Alton 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
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 who work with the service. 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 of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and two relatives about their experience of the care provided. We additionally received emailed feedback from one relative about their experience of the care provided. We spoke with eight members of staff including care workers, a domestic worker, the registered manager and a director. We spoke with one healthcare professional and received email feedback from three others.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three 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 provider to validate evidence found.
Updated
24 July 2021
About the service
Alton House Care Home accommodates up to 18 people in one adapted building, some of whom are living with dementia. At the time of the inspection the home was providing care and support to16 people.
People’s experience of using this service and what we found
The provider did not have sufficient oversight of all of the systems in the service. When safeguarding concerns were highlighted to the provider, they did not investigate these in a robust way or demonstrate they used this as an opportunity to learn and make improvements. We have made a recommendation about this. The provider has told us of their plans to improve this.
The provider had not notified CQC about an important event that happened in the service which meant this could not be monitored. We have made a recommendation about this.
Improvements to other quality assurance systems had recently been implemented. These had already driven improvement in some areas of service provision.
Effective systems were in place to prevent and control the spread of infection, and to manage medicines safely.
Risks associated with people’s needs and health conditions were effectively assessed, monitored and mitigated. People’s needs were met in a personalised way. Staff knew people well and understood how to support them safely.
Recruitment practices were safe and there were sufficient numbers of staff available to meet people's needs. Staff told us they had enough training to carry out their roles effectively and were well supported.
The provider worked well with healthcare professionals to ensure joined up care and good outcomes for people.
People were happy living at Alton House Care Home and spoke positively about the care they received. The service had a positive person-centred culture. People, relatives and staff provided us with positive feedback about the registered manager. They also told us they would recommend the home to others.
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 16 October 2019).
Why we inspected
We received concerns in relation to person-centred care, infection control and the premises and equipment. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this 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.
We have found evidence that the provider needs to make improvement in the well-led domain. Please see the well-led section of this full report. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
Follow up
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.