Archived: Autumn House Nursing Home

Updated 20 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 19 April 2017 and was unannounced. It was undertaken by two inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We looked at a range of information we held about the service which included the action plan the provider had sent us following our last inspection. We also looked at notifications the manager had sent us about significant incidents. Statutory notifications include information about important events which the provider is required to send us by law. We had discussions with the local authority to gain their views on the quality of service. We used this information to help us plan the inspection.

We spoke with 11 people who used the service and four relatives. We spoke with the manager, area manager, the clinical lead, three care staff, two agency staff and a visiting health professional.

We looked at seven people's care records, staff rotas, training records, the systems in place to monitor and improve the service. We did this to check the standards of care being delivered.

Updated 20 June 2017

This inspection took place on 19 April 2017 and was unannounced. At our previous three inspections we had found that care was not always safe, effective, caring, responsive or well led. At our last two inspections we had rated the service as Inadequate, placed it into special measures and begun enforcement action against the provider. At this inspection we found some improvements had been made however we remain concerned about the overall management of the service and the lack of continuous improvement. We found that the provider was still in breach of three Regulations of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating for this service is inadequate and it will remain special measures.

Services in special measures will be kept under review and the expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Autumn House Nursing home is a home providing accommodation, personal and nursing care for up to 67 people. At the time of the inspection 45 people were using the service. The service was in administration.

There was a manager in post who was in the process of registering with us. 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 systems the provider had in place to monitor and improve the service had not been fully effective in making the required improvements. Lessons had not been learned following incidents with the deployment of agency staff. People's medicines were still not being managed safely. People did not always receive their medicines at the required times.

There were insufficient numbers of suitably trained effective staff to safely meet the needs of people who used the service. Risks of harm to people were not always minimised. Action was not always taken following incidents that put people at risk and staff did not always know or follow people's risk assessments.

People were supported to eat and drink sufficient amounts to remain healthy, however people complained about the quality of food available.

People were supported to seek advice from health care professionals when they became unwell or their needs changed. However the appropriate health care support was not always sought in a timely manner.

People were not always treated with dignity and respect and their right to privacy was not always upheld. People did not always receive care that met their individual needs and preferences due to a lack of available, effective staff.

People were kept informed and involved in the running of the service through regular meetings. However people expressed concern about the frequent change of management and the use of agency staff.

People and their relatives knew how to complain however action was not always taken to satisfy people's complaints in relation to the use of agency staff.

There was a range of hobbies and interests available to people if they chose to join in. People's choices were respected.