Austen House

Updated 4 October 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 carried out by three inspectors and a specialist advisor.

Service and service type

Austen House is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Austen House 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 not a registered manager in post. However, an application had been submitted to CQC by the current manager to register.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed notifications and information we had received about the service since the last inspection. We contacted the local authority for feedback regarding 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 eight members of staff including the manager, nurses, care assistants, maintenance staff and an administrator. We reviewed a range of records. This included six people’s care records and multiple medicines records. We looked at four 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 also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 4 October 2022

About the service

Austen House is a residential care home providing personal and nursing care for to up to 79 people. The service provides support to older people and younger adults who may also have dementia. At the time of our inspection, there were 73 people using the service. Austen House accommodates people across four units in one building. Each unit has separate adapted facilities. Two of the units specialise in providing care to people living with dementia.

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

Medicines were not always managed safely. People and staff felt there were not always enough staff deployed and the provider had not ensured sufficient staffing levels in order to safely meet the needs of people. The provider had not ensured risks and actions identified in relation to fire had been undertaken. We recommended the provider reviews their recording and documentation regarding incidents and accidents. People told us they felt safe. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse.

People were not always 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 always support this practice. We recommended the provider improves the decor of the premises in order to make it more dementia friendly. We also recommended the provider review their staff training provision in line with current best practice guidance.

The provider did not ensure systems were embedded to ensure compliance with the fundamental standards. The duty of candour was not always followed when required.

Staff worked well with people, families and health and social care agencies to support people’s wellbeing. People reported that they were supported with their nutritional requirements. Staff knew people they supported well and cared about their wellbeing.

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 good (published 14 November 2019).

Why we inspected

We received concerns in relation to people’s nursing care needs, staffing levels and documentation. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 requires improvement based on the findings of this inspection.

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

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

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 good governance, medicines management, staffing, fire safety, duty of candour and the Mental Capacity Act. 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.