Aslockton Hall Nursing & Residential Home

Aslockton Hall Nursing & Residential Home is a care home providing personal and nursing care to older adults, some of whom were living with dementia. The service can support up to 62 people in one adapted building. There were 27 people living at the home at the time of the inspection.

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

People received safe care and treatment which was provided in a way that reduced the risks to their health and safety. Safeguarding procedures were followed. There were enough staff to provide safe care. The home was clean and tidy. More domestic staff were being recruited to ensure this continued. Medicines were well managed. There was learning when accidents and incidents occurred.

People’s needs were assessed prior to them living at the home, ensuring their care and support needs could be met. Staff were well trained, skilled, and experienced. People received support with their meals where needed. People had regular access to health and social care professionals. The home environment was suitable to people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were kind and caring and treated people with respect. Personal care was provided in a dignified way. Privacy was respected at all times. People were encouraged to do things for themselves, but support was always available where needed.

People received person-centred care and were encouraged to give their views about their care needs. Complaints were managed appropriately. Staff communicated with people in a way that did not discriminate. End of life care had been discussed with people and care plans were in place to ensure people’s specific requirements could be met.

The home was well managed and improvements had been made since our last inspection in areas such as medicines and infection control. There was a positive atmosphere at the home and people enjoyed living there and staff enjoyed working there. Regulatory and legal requirements were met. People told us they would recommend this 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 and update

The last rating for this service was requires improvement (published 25 September 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

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.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aslockton Hall Nursing & Residential Home on our website at www.cqc.org.uk.

Follow up

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

We found the following examples of good practice.

The provider had arrangements in place to help prevent the spread of COVID-19 and other infections. All staff received training on the correct use of PPE and infection control. The management team did regular checks on staff to ensure they were following infection control procedures. The management team also regularly audited all their infection control practices to ensure staff were following them.

The provider had arrangements in place to ensure people and staff were tested for COVID-19 in accordance with current government guidance. Risk assessments were carried out with people and staff to ensure they could safely live and work at the service.

There were restrictions on visiting the service. There was a clear system for visitors in place to ensure they followed the current guidance on the use of personal protective equipment (PPE) and social distancing. All visitors were screened for symptoms of respiratory or other infections before being allowed to enter the home. There was visible information about minimising the risk of infection throughout the home.

The home was clean and well maintained throughout. There was a program of enhanced cleaning to reduce the risk of infection. This included increased cleaning of frequently touched areas e.g. doors and handrails.

The provider had ensured that people were able to maintain contact with relatives using technology. For example, people were supported to have video calls with relatives. The registered manager and their team had regular contact with relatives updating them on visiting restrictions and other key information about infection control.

The registered manager was planning how to arrange safe visiting during the winter in accordance with current government guidance. This included setting aside space for visitors to have rapid testing and await the results safely.

Aslockton Hall Nursing & Residential Home is a residential and nursing home providing personal and nursing care to 29 people aged 65 and over at the time of the inspection. The service can support up to 62 people in one adapted building which has two floors.

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

Medicines were not always stored safely, and some people did not have guidance for their “as required” medicines for staff to follow. Three people were not given their medicine at the correct time in accordance with their prescriptions.

There were not always sufficient staff available to meet people’s needs. People, relatives and staff had mixed views about the availability of staff. There were times during the day where staff were not able to meet people’s needs in a timely manner. The issues with staffing levels also impacted on how frequently some people had their care plans and risk assessments reviewed.

People were not consistently protected from the risks associated with acquired infections. Staff did not always use personal protective equipment correctly, and people shared the slings used for hoisting them. Shared equipment like this increases the risk of infection being transferred from one person to another. The registered manager took immediate action to address these issues.

Audits of the quality of care were not always effective at identifying issues. There was a plan for improving the quality of the service, but neither the audits or the plan had been effective in identifying the issues we found on this inspection. There were areas of staff training that were not up to date. Feedback from the local authority quality monitoring audit had not always been acted on.

The registered manager had ensured that people and staff had timely access to testing for COVID-19. The provider had also updated their policies and risk assessments to take into account the specific risks posed by COVID-19.

People felt they were cared for safely, and relatives felt their family members were safe living at the service. Staff understood how to recognise and report concerns or abuse. Staff received training in safeguarding and felt confident to raise concerns about the people they cared for. People’s needs were assessed, and any risks associated with their health conditions documented. Risks associated with the service environment were assessed and mitigated. Accidents and incidents were reviewed and monitored each month to identify trends and to prevent re-occurrences.

People and relatives felt able to speak up about the quality of care and make suggestions for improvement and were confident the registered manager would take action. Staff said they felt part of a team and were well supported by their colleagues and the registered manager.

The registered manager and staff team worked with external health and social care professionals to improve people’s care and quality of life.

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 under the previous provider was requires improvement (published on 6 April 2018) and there were three breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. Since the last inspection, published April 2018, the provider changed legal entity.

The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about unsafe care practices. The concerns were shared with the local authority, who carried out four safeguarding investigations. The local authority concluded that one of the concerns was not substantiated, and their investigations for the other three concerns were inconclusive.

A decision was made for us to inspect and examine those risks and follow up what improvements had been made since we last visited the service. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-Led only. Our report is only based on the findings in those areas at this inspection. The ratings from the previous comprehensive inspection for the Effective, Caring and Responsive key questions were not looked at on this occasion. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains Requires Improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this full report. 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 Aslockton Hall Residential & Nursing Home on our website at www.cqc.org.uk.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified two breaches of regulation in relation to the management of medicines at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

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 also request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.