Albury House

Updated 23 January 2024

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 1 inspector 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.

Service and service type

Albury House 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. Albury House 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.

Inspection activity started on 8 November 2023 and ended on 7 December 2023.

What we did before the inspection

We reviewed information we had received about the service. We contacted the local authority commissioning team for their feedback about 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 2 people who lived at Albury House and 3 relatives about their experience of the care provided. We observed interactions between staff and people in communal areas. We spoke with 5 members of staff including the registered manager who was also the nominated individual, general manager, and care staff. We reviewed a range of records. This included 3 people's care and medication records. We looked at 4 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 23 January 2024

About the service

Albury House is a small family run care home which provides personal care and accommodation for up to 12 older people. At the time of the inspection, 11 people were living at the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The provider did not have a comprehensive oversight of the service. Following the last inspection improvements had not been made in the areas of greatest concern.

We identified shortfalls relating to checks on staff suitability to be employed in a care role, the maintenance of records relating to care and the building, the Mental Capacity Act 2005 (MCA)/Deprivation of Liberty Safeguards [DoLS] procedures and meeting regulatory requirements.

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 and in their best interests; the policies and systems in the service did not support this practice.

Care records and risk assessments were not always person-centred and lacked detail. Some risks were not appropriately assessed so measures could not be put in place to keep people safe.

Medicines were not always managed safely. Medicines audits were not clearly documented, and some medicine care plans were out of date. Most people received their medicines.

Staff, people and relatives were not always engaged with in line with the provider’s policies.

Staff had not received training in the MCA, or in learning disabilities and autism. Staff had received training in other aspects of care. There were enough staff to care for people safely.

People were supported to eat and drink enough to maintain their health. The provider worked well with visiting healthcare professionals and ensured people received healthcare support whenever they needed it.

People and relatives said the care they received was good. We observed staff knew people’s needs and gave person-centred care.

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 6 April 2023). At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider review staff training. At this inspection we found that sufficient improvements had not been made in this area. We had recommended that the provider review their information sharing systems, we found that the provider had made improvements in this area.

Why we inspected

We received concerns in relation to overall management of the service and the safety of care. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 remained requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective 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. The provider took action to reduce immediate risks to people during the inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Albury House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the provider’s oversight and management of the service, recruitment processes, mental capacity and best interest decisions, staff training and display of ratings.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.