Background to this inspection
Updated
8 September 2022
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 three inspectors.
Service and service type
Attlee Court 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. Attlee Court 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with 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 three people who used the service and three relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, regional manager and care workers.
We reviewed a range of records including four people’s care records including multiple medication records. We reviewed a variety of records relating to the management of the service. We looked at two staff files in relation to recruitment and staff supervision and observed staff interacting with people.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
8 September 2022
About the service
Attlee Court is a residential care home providing personal care for up to 68 people. Some people using the service were living with dementia. At the time of our inspection, there were 45 people using the service. Attlee court accommodates people on two separate units.
People’s experience of using this service and what we found
We carried out a tour of the home with the deputy manager and found several areas that required a deep clean. Following our inspection, the registered manager confirmed a deep clean of the home had taken place.
During our inspection, we identified some concerns regarding maintenance of equipment. The registered manager took action to address these issues.
Risks in relating to people's care were identified and managed safely. However, one person's moving and handling care plan did not document loop configuration to use. Following our inspection, the registered manager confirmed this had been updated and completed.
We found missed signatures on medication administration records (MAR’s), and topical medication was not always signed for when given. Some people were prescribed medications on an ‘as and when’ required basis, often known as PRN. Some people did not have PRN protocols in place, and MAR sheets didn't record why PRN medicine was required and whether it was effective. Medication audits identified similar themes and following this, supervision sessions took place to address the issues with staff. We made a recommendation for safe medication systems to be embedded into practice.
The service was not always person centred. Some care planning documentation was found in a lounge area. The home was not always dementia friendly. There was a lack of signage to help people navigate around the home.
The provider had a recruitment process in place which helped them employ suitable staff. We found there were enough staff available to meet people's needs.
People were safeguarded form the risk of abuse. Accidents and incidents were monitored and analysed to mitigate future incidents.
We observed staff interacting with people and found they knew people well and supported them in line with their needs and preferences.
The provider had a range of audits which were carried out by the management team. However, some audits had not identified concerns we raised during our inspection. For example, the infection control audit had not identified the home required a deep clean. We also identified some concerns with maintenance of equipment. These issues were promptly address by the registered manager after out site visit.
People were involved in the home and their feedback was used to develop the service.
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 requires improvement (published 31 October 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.
Why we inspected
The inspection was prompted in part due to concerns received about staffing, training, management and risks. A decision was made for us to inspect and examine those risks. 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 remained requires improvement, based on the findings of this inspection. We identified a breach of regulation in respect of good governance.
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 COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Attlee Court on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.