Archived: Aslockton Hall Nursing & Residential Home

Updated 7 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014

Aslockton Hall Nursing & Residential Home is a ‘care home with nursing’. 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. Aslockton Hall Nursing & Residential Home accommodates up to 62 people in one adapted building. At the time of our inspection 39 people lived at Aslockton Hall Nursing & Residential Home.

This inspection took place on 21 and 23 November 2017 and the first day was unannounced.

On day one of the inspection, the inspection team included two inspectors, a specialist professional advisor who was a nurse and two experts 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. Their area of expertise was in the care of older people. One day two, the inspection team consisted of one inspector.

Before the inspection we looked at all of the key information we held about the service, this included whether any statutory notifications had been submitted. Notifications are changes, events or incidents that providers must tell us about. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We also contacted the local commissioning teams. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority or by a health clinical commissioning group. We also checked what information Healthwatch Nottinghamshire had received on the service. Healthwatch Nottinghamshire is an independent organisation that represents people using health and social care services.

During the inspection we observed care and spoke with 16 people who used the service, three relatives or other visitors, two visiting healthcare professionals, a domestic staff member, a housekeeper, the medication coordinator, the activities coordinator, two care staff, two nurses, the manager and representatives of the provider. We looked at the relevant parts of the care records of eight people who used the service, five staff files and other records relating to the management of the service.

Updated 7 April 2018

This inspection took place on 21 and 23 November 2017 and the first day was unannounced.

Aslockton Hall Nursing & Residential Home is a ‘care home with nursing’. 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. Aslockton Hall Nursing & Residential Home accommodates up to 62 people in one adapted building. At the time of our inspection 39 people lived at Aslockton Hall Nursing & Residential Home.

The 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. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection visit the manager was not registered but was going through the process to become registered. The manager is now registered.

During our previous inspection on 6 and 7 September 2016 we rated this service as ‘Requires Improvement’ overall. At this inspection, we also rated this service as ‘Requires Improvement’ overall and the well-led question was rated ‘Inadequate’.

We also identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection. You can see the action we have told the provider to take at the back of this report.

Risks were not always managed so that people were protected from avoidable harm.

Sufficient staff were on duty but they were not effectively deployed to meet people’s needs at all times. Some medicines management practices required improvement though people received their medicines as appropriate.

The home was clean but staff did not always follow correct infection control practices. Themes and trends in relation to accidents and incidents were reviewed and investigations of specific incidents were carried out though action taken in response to specific incidents was not always clearly documented and lessons were not always learned.

Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Staff were recruited through safe recruitment practices.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

The premises had not been adapted to ensure that it met people’s needs especially those people living with dementia. People received sufficient to eat and drink but the mealtime experience upstairs required improvement. Staff received appropriate supervision but did not attend dementia training and appraisals were being planned but had not been completed.

People’s needs and choices were assessed and care was delivered in a way that helped to prevent discrimination and was in line with evidence based guidance. People’s healthcare needs were monitored and responded to appropriately.

People were cared for by staff who were pleasant and kind, however, staff were rushed and task orientated. Staff did not always respect people’s privacy and dignity. However, they did promote people’s independence and people’s relatives and friends were able to visit them without any unnecessary restriction.

People were involved in decisions about their care and support and information was available in accessible formats. Advocacy information was made available to people.

Activities required improvement. Care records did not always contain information to support staff to meet people’s individual needs. Processes required improvement for supporting people with end of life care where appropriate.

People were involved in planning their care and support. People were treated equally, without discrimination. The manager had limited knowledge of the Accessible Information Standard, however efforts had been made to ensure people with communication needs and/or sensory impairment received appropriate support. Complaints were handled appropriately.

The provider was not fully meeting their regulatory responsibilities and systems in place to monitor and improve the quality of the service provided were not fully effective.

A clear vision and values for the service were in place. However, we observed that staff did not always act in line with those values.

Staff felt well supported by the manager. People and their relatives were involved or had opportunities to be involved in the development of the service.