Austin Rose Care Home

Austin Rose Care Home is a residential care home providing personal and nursing care to up to 80 people aged 65 and over. At the time of our inspection there were 64 people using the service. The home accommodates people across three floors each of which has separate adapted facilities.

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

There was sufficient numbers of staff to meet people’s needs. People felt safe in the home. Clear care plans and risk assessments were in place for all people. The provider had a clear system in place to manage incidents affecting people's safety.

Assessment of people's needs were carried out prior to people moving into the home. Staff told us they felt supported. People enjoyed the food. People received support from external healthcare providers when needed. The layout of the home allowed people to choose where they spent their time. The service was working within the principles of the Mental Capacity Act 2005.

All of the people and their relatives we spoke with were positive in their feedback about the care and support they received. Staff treated people with kindness and compassion. People told us their privacy was respected. People were involved in decisions about their care.

The registered manager ensured care plans were person centred and specific to individuals. Care plans provided staff with clear guidance on how to meet people’s needs. People’s communication needs were assessed. The provider had a clear complaints policy in place.

Audits were completed and effective. Where improvements were needed, they were actioned in good time. The registered manager carried out reviews of all individual accidents and incidents. Staff were given the opportunity to discuss their views.

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.

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 19 August 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing numbers and skills. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

A visitor room was divided by a clear wall. A microphone and speakers enabled communication during visits. That meant people could see their loved ones in a safe and comfortable environment.

Staff were allocated to work on a specific floor and staff from different areas did not mix during their break times. This helped to minimise the risk of spreading infection.

The laundry room had a one-way system for soiled laundry to enter the area and clean laundry to be processed and taken to people’s rooms. A specialist washing machine was available for items used by people who tested positive for COVID-19.

The registered manager made regular contact with staff members who were shielding or self-isolating. This supported staff wellbeing during the COVID-19 pandemic.

Austin Rose Care Home is a residential care home providing personal and nursing care to 80 people aged 65 and over at the time of the inspection.

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

People were safe and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had enough staff to support people safely. People received their medicines as prescribed. Staff followed infection control guidance and had access to personal protective equipment. Accidents and incidents were recorded and action taken to minimise risk for the future.

Staff had the skills and knowledge to meet people's needs. People's nutritional needs were met. People accessed health care when needed. The environment where people lived was well maintained and was clean and fresh.

People were supported by staff who were kind and caring and knew them well. Staff were compassionate and empathetic and had built good relationships with people. People's privacy, dignity and independence were respected by staff. People’s equality and diversity needs were respected.

People's support needs were assessed regularly and planned to ensure they received the support they needed. People's support was individualised. People were supported to take part in social activities. The provider had a complaints process which people were aware of to share any concerns.

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.

The service was not always well managed. Some records for medicines required improvement to give clear guidance to staff on how to administer them safely. Some risk assessments required more detail in order to give clear guidance to staff. The registered manager was known to people and made themselves available. The registered manager understood their duty of candour and was open and honest about the improvements they had needed to make since their last inspection. Spot checks and audits were carried out to ensure the quality of the service was maintained.

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 24 October 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when, to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• Risk assessments in relation to the health and safety of service users were mostly completed satisfactorily and steps had been taken to reduce risks to people. We identified some risk assessments which could be more detailed in order to clear guidance to staff, however these were in the minority and staff knowledge was good. The provider had greatly improved the quality of their risk assessments since their last inspection.

Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• The auditing of the service was more effective and was continuously improving the quality of the service.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Austin Rose is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Austin Rose can accommodate 80 people in one adapted building. At the time of our inspection there were 71 people living there. Austin Rose is a purpose-built nursing home and has a number of dining rooms, lounges outside spaces and other facilities for people to use such as a small cinema.

There was a registered manager at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.

The service was not consistently safe and had not kept people free from the risk of potential harm due to poor staff knowledge about risks and a lack of risk assessments concerning how to support people to eat safely.. Other areas of the service were safe such as the processes to report safeguarding and the administration of peoples’ medication. Austin Rose was clean and people were protected from the risks of cross infections.

The service was not consistently effective as staff had received very little supervision and had not received timely training in all areas. While the home was clean and spacious it did not meet the needs of people living with dementia well. People had food to eat that they enjoyed but were not supported to eat their meals in a way that encouraged them to enjoy the mealtime as a social activity. There were policies and systems in place to support appropriate practice in relation to the Mental Capacity Act. However, people were not consistently supported to have maximum choice and control of their lives and staff did not consistently support them in the least restrictive way possible. The provider was following the legal requirements of the MCA and had submitted DoLS applications as necessary. Where these had been authorised, the provider was compliant with the conditions of the authorisation. However, the provider had not properly trained or prepared staff to understand the specific requirements of DoLS. People had good access to healthcare professionals.

People were not consistently supported in a caring manner as some aspects of how people were supported to move was not dignified. We saw that independence was promoted for people who lived at Austin Rose for short periods of time but there was no focus on this part of peoples’ life if they lived at the home on a long-term basis. It was not clear how people were meaningfully involved in their care. People and relatives told us that staff were kind and caring and we saw examples of compassionate care.

The service did not always respond to people’s needs well. People did not have sufficient access to activities or meaningful occupations. People and relatives had access to a complaints process but not all complaints had been recorded and dealt with by this process, so some learning may have been missed. Peoples’ needs had been assessed but this process did not always include the person or their relatives in a meaningful manner. People had basic end of life plans if needed.

Austin Rose was not always well led. There were concerns about the poor quality of the auditing process which meant that issues were missed and improvements not made. We also found that people were not as involved in the running of the home or their care as they could be. Everyone we spoke with said they thought the management of the home was good and the registered manager understood their responsibilities under the law.

We found two breaches of regulation during this inspection. You can see what action we told the provider to take at the back of the full version of the report.