Archived: Allenbrook Nursing Home Limited

Updated 1 November 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 was planned to check 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.

This inspection took place on 27 and 29 June 2018 and was unannounced. The inspection was carried out by an inspector, a 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. Their area of expertise was the care of older people. The specialist advisor was a nurse with a specialism in dementia care.

As part of our inspection planning, we referred to information and feedback shared by a local authority safeguarding team and commissioners of the service. We also checked whether any information was available from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We referred to other information we held about the service to help inform our inspection planning. This included notifications, which contain information about important events which the provider is required to send us by law. We also viewed monthly reports submitted by the provider, which they are required to send to us as part of our enforcement action from the last inspection in November 2017.

During our inspection, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with three people living at the home and eight visiting friends and relatives. We sampled records relating to nine people’s care and recruitment files of three staff members at random. As part of our inspection we also spoke with three care staff, two nurses, a new clinical lead, a retired nurse who supported care planning at the service, the manager, and three healthcare professionals involved with the home. We sampled other records relating to the quality of the service.

Updated 1 November 2018

This inspection took place on 27 and 29 June 2018 and was unannounced. We last inspected this service on 1 and 2 November 2017. At our last inspection, we identified five breaches of the regulations and rated the service ‘Requires improvement’ overall. Following the last inspection, we met with the provider to discuss what they would do and by when, to improve the overall quality of the service. We also took enforcement action in relation to our concerns about the governance of the service. This enforcement action required the provider to share monthly audits with us outlining their oversight and governance of the service.

At this inspection, we found one breach of the regulation had been met and some improvements have been made. However, the provider was still in breach of four regulations related to safeguarding, safe care and treatment, good governance and notifying the Commission of specific events and incidents as required. We have rated the service ‘Requires improvement’ overall for a fourth time. We have decided the provider is still required to submit monthly reports to the Care Quality Commission because sufficient improvements have not been made since our last inspection and they remain in breach of the regulations.

Allenbrook Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Allenbrook Nursing Home accommodates up to 36 people in one building. There were 28 people living at the home at the time of our inspection.

A new manager had joined the service in February 2018 and had not yet registered. 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.

People told us they felt safe. However, further improvements were needed to ensure all people’s risks were safely managed including people’s equipment use and support with their medicines. Further improvements were required to ensure people would always be protected from the risk of abuse. We received mixed feedback around whether there were enough staff to meet people’s needs and recruitment checks had not been carried out as planned.

People and relatives spoke positively about the care provided including meals offered. Staff showed awareness of people’s health needs and told us they found training useful. People told us they were given choices and their consent was sought, although improvements identified at the last inspection relating to the Mental Capacity Act (2005) had not been fully addressed. We saw people could access healthcare services and the home was being supported to drive further improvements in this area.

People told us staff were kind and caring. Staff showed care for people, however this had not informed a consistently caring and respectful approach. We observed task-based care from some staff which did not promote people’s dignity and positive experiences. People were not always well engaged with and involved in their care as far as possible.

People did not all have good access to activities and things they may have enjoyed. Further improvements were planned to ensure care planning recognised and met all people’s needs and preferences, including around end-of-life care. People and relatives felt able to complain and that this feedback would be used to improve their experiences.

Systems to assess, monitor and improve the quality and safety of the service were not effective. Concerns at our last inspection had not been fully addressed and the provider remained in breach of the regulations. There was a new manager and fully recruited staff and nursing team. People and relatives with generally expressed a positive experience of the service, although they felt there were not always enough staff or things to do. People were not engaged and involved in the service as far as possible to drive improvements and positive experiences of using the service.

You can see what action we told the provider to take at the back of the full version of the report.