Archived: Autumn Vale Care Centre

Updated 21 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider had made necessary improvements since our last visit and met the legal requirements and regulations associated with the Health and Social Care Act 2012. The purpose of the inspection was also to look at the overall quality of the service and to provide a rating under the Care Act 2014.

The inspection was carried out on 08 December 2016 and was unannounced. On 20 December 2016 we asked the provider to submit further evidence in relation to staffing in the home. The inspection team consisted of two Inspectors, two specialist professional nursing advisors, and an expert by experience. The specialist advisors who accompanied us were an occupational therapist and a nurse with expertise in supporting people with dementia related nursing needs. An expert by experience is someone with personal experience of having used a similar service or who has cared for someone who has used this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that requires them to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service including statutory notifications. Statutory notifications include information about important events which the provider is required to send us. We spoke with the local authority social services, clinical commissioning group professionals and the local authorities safeguarding team to ask their feedback about the services provided to people in Autumn Vale.

During the inspection we spoke with 14 people who lived at the home, five relatives and nine staff members. We also spoke with the manager, regional manager, the provider and other senior representatives of the provider.

We viewed care plans relating to 11 people who lived at the home. We also carried out observations in communal lounges and dining rooms and used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us due to complex health needs.

Updated 21 January 2017

Autumn Vale Care Centre is a modern purpose built home that shares the same site with another service operated by the provider called Heath Lodge. Autumn Vale provides accommodation and nursing care for up to 69 older people, some of whom live with dementia. At the time of this inspection 43 people were living in the home.

This inspection took place on 08 December 2016 and 20 December 2016 and was unannounced. When we last inspected the service on 18 and 25 May and 01 June 2016 the provider was not meeting the required standards in all of the areas we looked at. We found breaches of the regulations in relation to providing safe care and treatment, staffing levels across the home, supporting staff development, consent was not appropriately sought or documented, meeting people’s individual social needs and ensuring governance systems were effectively operated to monitor the quality of the service provided. We served the provider with a notice telling them they needed to improve by 31 October 2016.

At this inspection we found that improvements had been made, however there were areas that continued to require improvement, particularly in relation to the service being well led.

People were supported by sufficient numbers of suitable staff, however further improvements were required with assessing staffing levels particularly in the dementia care unit where staff were less responsive to people’s needs. The provider had successfully recruited and built a permanent staff group within the home and used minimal temporary staff. Safe and effective recruitment practices were followed to make sure that staff were of good character and had the experience and qualifications necessary for the roles they performed.

Staff were knowledgeable about the risks of potential abuse and knew how to report any concerns. Risks to people’s safety and welfare were responded to and addressed to reduce identified risks. People were supported to take their medicines safely and in an appropriate way.

People and their relatives were positive about the skills and abilities of the permanent care staff. Training had been provided to staff in key areas, and further training was booked for the future. Staff told us they felt supported by their line manager, but felt anxious about the lack of consistent management due to the departure of numerous managers in the last years. Staff told us, they had supervision meetings to review their performance and professional development.

People’s consent was sought prior to care being provided and where people lacked the capacity to make their own decisions, the requirements of the Mental Capacity Act 2005 were followed. People at risk of weight loss were supported adequately and those at risk were responded to promptly. People were supported by a range of health and social care professionals with their health needs when they required this.

People were cared for in a kind and compassionate way by staff who knew them well. Staff were observed to have developed positive and caring relationships with people who lived at the home. When personal care was provided, this was carried out in a respectful way that promoted people’s dignity and took full account of their needs and wishes.

People were able to pursue their individual interests however there were not always sufficient opportunities for people to take part in meaningful activities. People and their relatives knew how to raise concerns; however the constant changes in management meant people were not always confident that complaints would be dealt with.

There had not been a long standing, consistent manager in the home for three years and the last home manager had resigned from their post shortly before this inspection. None of the managers who managed the home for various length of time registered with CQC. Staff, people and relatives felt anxious about the constant management changes at the home.

Improvements had been made to monitor and improve the quality of care people received by reviewing the systems used; however, these were not always consistent in identifying areas for improvement. People's records had been reviewed and transferred to a new care planning system; however, some improvements to recording were still required to ensure records were accurate. The provider had undertaken a comprehensive review of Autumn Vale and all the other Gold Care Homes. They recruited a number of senior managers to support the changes they wished to make in all their homes. We saw plans were developed to support and drive improvement across a number of the provider’s homes, however at the time of inspection it was too early to measure their effectiveness and this will be further reviewed.