Alton Manor Care Home - Portsmouth

Updated 5 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 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 Manor 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 did not have a manager registered with the Care Quality Commission. This means that the provider alone is legally responsible for how the service is run and for the quality and safety of the care provided.

A manager was in post and told us they were currently in the process of applying to be registered. They had been at the service for approximately two months at the start of our inspection.

Notice of inspection

This inspection was unannounced. Inspection activity started on 4 August 2022 and ended on 19 August 2022. We visited the location’s service on 4 August 2022, 8 August 2022 and 12 August 2022.

What we did before the inspection

We reviewed information we had received about the service since their last inspection. 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 nine people who used the service and three relatives about their experience of the care provided. We spoke with eight members of staff including the director, manager, senior care workers, care workers and cooks. We spoke to one professional during the inspection.

We reviewed a range of records. This included two people’s care records in detail and a further four care records in part as well as multiple medication records. We looked at five 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. We continued to seek clarification from the provider to validate evidence found. We received email feedback from two professionals who regularly visit the service.

Updated 5 October 2022

About the service

Alton Manor Care Home is a residential care home providing personal care to up to 34 people living with dementia and/or physical frailty in one adapted building. At the time of our inspection 25 people were living at the home with one person in hospital.

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

Infection control processes were not always managed safely and placed people at risk of harm.

People were not always supported to have maximum choice and control of their lives and staff did not always 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. We have made a recommendation about this.

Current guidance on isolation of people on admission was not always followed. We made a recommendation about this.

Care plans and risk assessments although improved still required further updating and improvement, we made a recommendation about this.

Staff felt well supported by the manager and told us overall they were happy working at Alton Manor Care Home. Staff in the service worked well with each other and external professionals to ensure good health outcomes for people.

Medicines were managed safely, and the provider recruited people safely.

We observed positive and kind interactions between staff and people. Relatives felt staff treated people with dignity and respect and we observed staff respecting people's right to privacy.

People’s rooms were personalised, and the layout of communal areas had significantly improved.

People knew how to raise concerns. They had confidence in the registered manager. Incidents and accidents were monitored by the registered manager. Where accidents and incidents occurred the registered manager ensured appropriate action was taken to reduce the likelihood of injury or reoccurrence.

The provider and the manager demonstrated a willingness to make further improvements and had identified areas for improvement prior to the inspection through their quality assurance systems and processes. They planned to ensure the service consistently provided good, safe, quality care and support. Further progress was still needed to fully embed and sustain these improvements.

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 May 2021). There were three breaches of regulation in relation to regulation 12, Safe Care and Treatment, regulation 17, Good Governance and 11, Need for Consent. We imposed a condition on the providers registration which required them to submit a monthly report to the Care Quality Commission on the actions being taken to ensure improvements were being made to the quality and safety of the service.

The is the third consecutive rating of requires improvement for this service however, we have seen significant improvements at this inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, poor care, management and culture of the service, communication, medicines management, activities and confidentiality. A decision was made for us to inspect and examine those risks.

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

We have found evidence that the provider needs to make some improvement. Please see the safe, effective and well-led sections of this full report.

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