Adlington Manor

Updated 2 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, a nurse specialist advisor 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

Adlington Manor 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. Adlington manor 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 on both days of inspection.

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 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.

During the inspection

We visited the service and reviewed staffing levels and walked around the building to ensure it was clean and a safe place for people to live. We observed how staff supported people and provided care.

We spoke with nine people who use the service, four relatives and family friends, and 17 members of staff including the registered manager, deputy manager, nurses, care workers, and auxiliary staff. We spoke to three healthcare professionals.

We reviewed a range of records including seven people's care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were examined.

Updated 2 September 2022

About the service

Adlington Manor is a residential care home providing personal and nursing care to up to 70 people. The service provides support across two units, with one unit providing general nursing care, and the other units providing specialist care for people living with dementia. Each unit has single occupancy bedrooms across two floors with a variety of communal areas, adapted bathrooms and outdoor areas. At the time of our inspection there were 61 people using the service.

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

Risks to people were not always fully assessed and mitigated and we noted areas for improvement to ensure lessons were learnt when things went wrong. People’s views of staffing levels were mixed, and further work was necessary to address our previous recommendation about the induction and introduction of agency staff to the service. People generally felt safe, and staff understood their roles in keeping people safe. Medicines were securely stored, although improvements to care planning and record keeping were required. The home was clean and tidy.

Governance systems needed further embedding to ensure they were robust and drive quality and improvement in the home. A variety of checks were completed but these did not always lead to improvement across the wider setting. Meetings were held and people and families were generally happy with how they were supported. Staff felt able to raise ideas and told us communication was good.

Families and professionals spoke positively about how people were supported at end of life although further work was required regarding record keeping in this area. The quality of person-centred care planning varied. People generally felt they had choice and their communication needs were being met. People wanted more activities in the home and the registered manager had recently recruited a driver to help people access the community.

People were treated well by staff and generally felt involved in their care where possible, and that their privacy and dignity was respected.

People were supported to access healthcare services as needed. People were supported by staff who had the training and support they needed to do their role. People’s feedback about the quality of food varied, but the chef would offer alternatives if people did not like the menu options. People who required additional support to eat and drink received this and adapted equipment and utensils were used to promote independence.

People were supported to have maximum choice and control of their lives and staff 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 and update

The last rating for this service was requires improvement (published 28 October 2021). The service remains rated requires improvement. This is the second consecutive inspection where the service has been rated requires improvement.

The provider completed an action plan after the last focused inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection in the related key questions of safe and responsive we recommended that the provider ensures that all agency staff have an appropriate introduction and induction to the service; and recommended the provider considers current guidance of future care needs and updates this practice accordingly. At this inspection we found some improvements, but further development was required.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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.

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

Enforcement and Recommendations

We have identified breaches in relation to the assessment and mitigation of risk, and systems of oversight to ensure the quality and safety of the service.

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 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 to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.