Background to this inspection
Updated
9 February 2023
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 2 inspectors.
Service and service type
Alandale Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Alandale Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with 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 5 people who used the service and 8 relatives about their experience of the care provided. We spoke with 7 members of staff including the registered provider, registered manager, deputy manager, office manager and care staff. We observed interactions between staff and people in communal areas. We reviewed a range of records. This included four people's care records and multiple medication records. We looked at 3 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.
Updated
9 February 2023
About the service
Alandale Residential Home is a residential care home providing personal care to up to 35 people. The service provides support to older people some of who were living with dementia in one adapted building. At the time of our inspection there were 33 people using the service.
People’s experience of using this service and what we found
People and their relatives gave positive feedback about the service and support they received from staff. However, we found areas of the service which were not always well managed. Medicines administration and management was not always in line with guidance. Infection control risks such as incorrect bins being used had not been identified by the registered provider and registered manager. Accident and incident documentation, and oversight was not always robust. Risks to people’s health were not always mitigated through clear guidance for staff to follow. Staff did not always document checks completed on people to support complex health conditions.
The registered provider and registered manager did not complete regular audits on the service to ensure it was safe and identify any areas for improvement. There was a lack of oversight for areas highlighted within this report including medicines, accident and incidents management, weights management and reviewing and updating care plans.
People and relatives told us there was a positive culture within the service. 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. People were safeguarded from the risks of abuse. There were enough staff to meet people’s needs. Staff worked with stakeholders to ensure people received joined up care.
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 23 November 2017).
Why we inspected
We received concerns in relation to visiting the service. As a result, we undertook a focused inspection to review the key questions of safe 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. We have found evidence that the provider needs to make improvements.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alandale Residential Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to infection prevention and control, medicines management, risk management and governance and oversight at this inspection.
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.