We carried out a review of the data available to us about Augusta Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Augusta Court, you can give feedback on this service.
We found the following examples of good practice.
There was a robust system in place at the entrance to the home to ensure all visitors, including relatives, friends, professionals and tradespeople were prevented from spreading or catching infection.
Staff had received training which included infection prevention and control, how to safely put on and take off personal protective equipment (PPE) and hand hygiene. Staff were observed to wear their PPE appropriately.
An infection prevention and control (IPC) champion supported staff to understand their responsibilities and to use appropriate personal protective equipment (PPE). Senior staff undertook daily checks to ensure that staff were following good IPC practice.
Enhanced cleaning schedules were in place and included regular cleaning of high touch areas and additional deep cleaning. The home was clean and tidy.
We found the following examples of good practice:
People were well supported by staff to have telephone and internet contact with their family and friends. The service facilitated face-to-face visits in a manner which minimised the risk of infection spread, such as garden and window visits. An internal visiting area had been created for people to meet. This was accessed directly from an outside area and partitioning screens minimised the risk of infection spread.
The service ensured that visitors to the home were carefully screened so that they did not present a risk to people in the home. Visitors were asked a series of screening questions and had their temperature checked on arrival. Personal protective equipment (PPE) including face masks and aprons were provided for visitors before entering the home.
Plans were in place to isolate people if required, to minimise the risk of COVID-19 transmission, such as new residents admitted from the community. One to one care, activities and high levels of support were provided to those people required to isolate within their rooms.
Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and residents were regularly tested for COVID-19. The building was clean and free from clutter.
Additional cleaning of all areas and weekly auditing of infection prevention processes were carried out. Staff acted quickly to make any improvements needed. The service had good supplies of PPE which were readily available in stations throughout the service.
Effective welfare review and risk assessment processes monitored and supported staff who were clinically vulnerable or who required additional support.
Staff supported people's emotional and social wellbeing. Activities had been planned within the home to positively support people through a period of extreme change to their routines.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
People remained safe. Staff had a good understanding of safeguarding and there were systems and processes in place to keep people safe. A relative told us “The staff are very good; the security is very good. Anything wrong and I have a word with the manager.” The management of medicines continued to be safe. The registered manager had put measures in place to continue to improve medicines management at the home.
People's needs were assessed, before they moved into the home and regularly thereafter. One relative told us, “They discuss everything with me. They go through every aspect of her care. We have regular meetings…They seem to look at every aspect of her care and there’s a lot of things to consider.” People had access to a balanced diet and healthcare professionals as required. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People were treated with kindness and respect. We observed positive interactions between people and staff. Staff knew people well and had built trusting relationships. One person told us “The staff are exceptional. They’re first rate.”
Peoples independence continued to be promoted. People were encouraged to make their own decisions, where appropriate, and supported to be independent. People's privacy was respected. Staff were conscientious always knocked before entering people’s rooms.
Staff continued to be responsive and care was personalised to meet people’s needs. Staff were very knowledgeable about people's care and how they wished it to be provided. People and their relatives, where appropriate, were involved in reviews of their care. One person told us “I write my own care plan.” Complaints continued to be responded to in a timely manner and the provider ensured there were systems in place to deal with these appropriately. A person told us “You get immediate care, I’ve got no complaints.”
The home continued to be well-led. All of the people and relatives we spoke with told us they thought the home was well managed. Staff, people and relatives were very complimentary of the manager. Staff said they felt supported within their roles. Quality assurance systems remained effective. There were processes in place to assess, monitor and drive improvements in the quality of care people received.
Further information is in the detailed findings below.
Augusta Court is a residential care home which is registered to provide accommodation for up to 46 older people, the majority of whom are living with dementia. The home provides accommodation over two floors and there is a lift available to access the first floor. On the day of our visit 45 people lived at the home.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
People felt safe with the home’s staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm. Risks to people’s safety had been assessed and care records contained risk assessments to manage identified risks.
People were supported to take their medicines as directed by their GP. Records showed that medicines were obtained, stored, administered and disposed of safely. The provider’s medicines policy was up to date. There were appropriate arrangements for obtaining, storing and disposing of medicines.
Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely. People and relatives told us there were enough staff on duty and staff also confirmed this.
People told us the food at the home was good. There was a four week rolling menu displayed outside each dining room. Staff went round before each meal and showed people a sample of the choices available to them. Information regarding meals and meal times were displayed in the dining room.
Staff were aware of people’s health needs and knew how to respond if they observed a change in their well-being. Staff were kept up to date about people in their care by attending regular handovers at the beginning of each shift. The home was well supported by a range of health professionals. The registered manager said they had a good relaitionship with all the healthcare professionals who visited the home and that they worked well with them to meet people’s needs.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made and how to submit one. We found that the provider had suitable arrangements in place to establish, and act in accordance with the Mental Capacity Act 2005 (MCA). The registered manager and staff understood their responsibilities regarding The MCA and DoLS.
Each person had a care plan which provided the information staff needed to provide effective support to people. Staff received training to help them meet people’s needs. Staff received an induction and there was regular supervision including monitoring of staff performance. Staff were supported to develop their skills by means of additional training such as the National Vocational Qualification (NVQ) or care diplomas. These are work based awards that are achieved through assessment and training. To achieve these awards candidates must prove that they have the ability to carry out their job to the required standard. All staff completed an induction before working unsupervised. People said they were well supported and relatives said staff were knowledgeable about their family member’s care needs.
People’s privacy and dignity was respected. Staff had a caring attitude towards people. We saw staff smiling and laughing with people and offering support. There was a good rapport between people and staff.
The registered manager operated an open door policy and welcomed feedback on any aspect of the service. There was a stable staff team who said that communication in the home was good and they always felt able to make suggestions. They confirmed management were open and approachable.
There was a clear complaints policy and people knew how to make a complaint if necessary.
The provider had a policy and procedure for quality assurance. The registered manager worked alongside staff and this enabled her to monitor staff performance. A group manager employed by the provider visited the home regularly to carry out quality audits.
Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular meetings with people,relatives and staff enabling feedback to be sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.
The expert by experience spoke with people who were able to do so and to relatives who were visiting the care home. They also spoke with some staff and looked around the premises. Their feedback was positive. For example they reported, 'Augusta Court is an excellent rest home, geared towards caring for the elderly with dementia. The management, the provision of en suite facilities and a small kitchen in all residents' rooms, d'cor, standards of care, cleanliness, staff attitudes, level and quality of activities and the food provision are all of a very high standard.'
We spoke with four members of staff, who were on duty. We found that they had a good understanding of their roles and responsibilities.
We also gathered evidence of people's experiences of the service by looking at a selection of records. This included individual care records, risk assessments and review records. We found that care records provided care staff with adequate information to follow with regard to the delivery of care to ensure individual needs had been met.
Due to their disabilities many of the people accommodated were not able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. This tool allows us to spend time watching what was going on in a service and helps us to record how people spent their time, the type of support they get and whether they have positive experiences.
We spent 45 minutes watching care and support provided to seven people over lunch. We observed people being served their meal and also helped with hot drinks. We also observed people being assisted to leave the dining room when the meal had finished. We found that people had positive experiences.
We spoke with two relatives who were visiting. They told us they were very satisfied with the service provided and the care that had been delivered. One relative commented, 'On the whole they do a good job. The building is nice; there is plenty of room to move about. It is very pleasant from that point of view. The staff are very good, too!' The second relative said, 'Augusta Court has a lot to offer. They do try to keep people stimulated and active. The staff do look after people well.'
We spoke with four members of care staff who were on duty. They demonstrated they knew about the level of care that each person required. In addition, they were able to explain what was required of them to ensure people's identified needs had been met. They also told us they were well supported by the manager and well trained so that they were able to provide good quality care.
We spoke with the manager who explained how care records have been reviewed and updated. They also told us how the quality of service provision had been assessed and monitored.