Archived: Alwoodleigh

Updated 20 March 2021

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 Care Act 2014.

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

This inspection was carried out by three inspectors and a specialist advisor specialising in nursing care.

Alwoodleigh is a ‘care home’. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced on the day of the visit. We did this to discuss the safety of people, staff and inspectors with reference to Covid-19.

Inspection activity started on 16 December 2020 and ended on 26 January 2021. We visited the care home on 16 December 2020 and 7 January 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with eight members of staff including the registered manager, regional manager, nurse, senior care workers, care workers and the chef. We spoke with one relative about their experience of the care provided.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with two professionals who visited the service.

Updated 20 March 2021

Alwoodleigh is a nursing home providing personal and nursing care to 33 people aged 65 and over at the time of the inspection. The service can support up to 40 people.

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

People did not always receive safe care. Risks were not always identified and responded to appropriately following accidents and incidents. Care records did not always take account of risks and include guidance for staff to support people safely. We found concerns relating to the safety of the environment. Remedial action to ensure compliance with fire safety of the premises had not all been completed within set timescales.

Quality assurance systems were not always effective and did not drive improvement within the service. We found concerns relating to the management of risk and the safety of the premises. Learning was not always shared when things went wrong.

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.

Recruitment procedures were in place, but we made a recommendation to strengthen these.

Medicines were managed safely, and staff were knowledgeable about recognising and reporting abuse.

There were sufficient staff who were appropriately trained to support people safely. People were supported to access healthcare and maintain a nutritious diet.

Staff told us the registered manager was approachable, they felt supported and communication amongst the team was good.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 24 April 2018).

Why we inspected

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 coronavirus and other infection outbreaks effectively.

The inspection was prompted in part by notification of some specific incidents. Following one of these a person using the service died. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of accidents and incidents including falls and missing persons. This inspection examined those risks.

Some of these incidents are subject to or have the potential to be subject to a criminal investigation. As a result, this inspection did not examine the circumstances of these incidents.

The information CQC received about the incident along with other concerns we received indicated concerns about the management of risks, staff skills, communication within the service and recording. This inspection examined those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to people’s safety and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alwoodleigh on our website at www.cqc.org.uk.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.