Allerton Court

Allerton Court is registered to provide accommodation and personal care for up to 48 older people. At the time of the inspection 45 people were living at the home.

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

Whilst improvements around medicines had been made, further improvements were required. People received their medicines as expected, but we found medicines were not always stored correctly and the use of some medicines were not always documented as required. Quality monitoring systems were in place. However, audits had not identified issues related to medicines which were discovered during the inspection. People were supported by staff to remain safe.

Previously there were concerns around staff member’s availability for people, however during this assessment we found there were enough staff available to people and people’s needs were attended to in a timely manner. Risk assessments were in place to minimise any potential risk to people’s wellbeing. Staff were recruited in a safe way.

Whilst previously we had found that training was not always given or updated, at this inspection we saw staff received training and had been provided with an induction. Staff members felt able to approach the registered manager with any concerns. Staff knew people’s needs. People were assisted to receive food and drinks by staff where required. People were supported to maintain their health.

Staff were now aware of the requirements of the mental capacity act and had received training. People were supported to have choice and control over their lives and staff understood that they should support them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff ensured that people’s privacy and dignity was maintained.

People's care plans reflected their needs and preferences and staff understood the care that people required. Although at the previous inspection people felt that they were under-stimulated by lack of activities, this had been addressed with new activities introduced. The complaints procedure had been improved and complaints were dealt with appropriately in line with the procedure in place.

Feedback was taken from people and used to inform the service. People knew the registered manager and felt they were approachable.

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. (Report Published 23 January 2019). The service had been rated ‘requires improvement’ in each of the key questions.

There was a previous breach of regulation 17 (2) (b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the lack of oversight of the service. This had now been met.

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.

Quality assurance audits were carried out, but these did not identify concerns in all areas.

Administration, recording and storing of medicines given was not always done safely. Medicines were not always given as required and we saw medicine used past its use by date which could impact upon a person’s health and wellbeing. Staff did not always receive the training that they required to support people effectively. These issues were not identified within audits.

Staff were not always available to people and we saw long periods of time where people were left unattended. Staff understood the procedures they should follow if they witnessed or suspected that a person was being abused or harmed and risk assessments were in place. Staff were recruited safely. Accidents and incidents were responded to appropriately. The environment was hygienic and tidy.

Some staff members did not have a clear understanding of the Mental Capacity Act and how best to support people in line with its principals. We had not been notified where there had been an approval to deprive a person’s liberty. People liked the food provided and staff were supportive when people required assistance to eat. Staff gained people’s consent before assisting or supporting them. Staff received an induction prior to them working for the service and felt prepared prior to carrying out their role. Staff could access supervision and felt able to ask for assistance from management should they need it. Staff supported people’s healthcare needs.

Staff were caring in their interactions with people, but did not always give people their time. People’s privacy and dignity was maintained. People were encouraged to retain an appropriate level of independence and choices were given to people if they were able to make them. Family and friends were welcomed.

People were not consistently offered a stimulating environment. People knew how to raise complaints, but the recording of outcomes was not always in place. Care plans were in place and people’s preferences for how they wished to receive support were known and considered by the care staff. End of life plans were in place.

People and staff spoke positively about the registered manager. Meetings were held were people could voice their opinions. Feedback on the service was taken from people.

There was a registered manager in post and they were present during the 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.

You can see what actions we told the provider to take at the back of the full version of the report.

Our inspection was unannounced and took place on 02 June 2016. The service was last inspected on 03 March 2014 where it was found to be compliant.

The manager was registered with us as is required by law. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Medicines were given appropriately and the recording of their distribution was clear and concise; they were kept and disposed of as they should be. People’s long term health needs were addressed and people saw medical professionals when they needed to. People received adequate food and drink.

There were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. People told us that they were kept safe. People were able to raise any concerns they had and felt confident they would be acted upon.

People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005. Staff interacted with people in a positive manner and their consent was sought before any care was carried out. Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

People, their relatives and staff spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision, allowing staff to understand their roles, and responsibilities were in place. Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were effective. Quality assurance audits were undertaken regularly and the provider gave the registered manager support.

Notifications were sent to us as required, so that we could be aware of how any incidents had been responded to.

During our inspection of this home on 28 October 2013 we found non-compliance with some aspects of the safety of the premises. We identified that action was needed to prevent burns from hot pipe work, flooring trip hazards and ensure that the premises were adequately decorated. We carried out this inspection to find out if improvements had been made and found that the overall high risks to people had been managed.

At the time of our inspection 45 people lived at Allerton Court. During our inspection we spoke with eleven people who lived there, three relatives/ visitors, six staff and a visiting health care professional.

Everyone we spoke with were complimentary about the overall service provided, their care, and the staff. One person who lived there told us, 'I have lived here for a long time. I am happy and I like it here.' Another person said, 'I am looked after well and the staff are really nice. One relative told us, 'I have not got any concerns'. Another relative said, 'They are well looked after'.

We saw that people's needs had been assessed by a range of health care professionals including specialist doctors and district nurses. This meant that people had their health care needs monitored and met.

We found that steps had been taken to prevent abuse and that staff knew what they should do if they had any concerns.

We determined that action was needed to prevent burns from hot pipe work, to prevent flooring trip hazards, and ensure that the premises were adequately decorated.

We found that staffing levels were adequate to ensure that people's needs were met and that they were safe.

We found that some systems had been used to monitor how the service had been run and people had been encouraged to give their views about the service provided.

We spoke with one person living at the home about their medication. They told us, 'The staff look after my tablets as I do not want that responsibility. They always give me my tablets at the time I should have them'.

We spoke with eight people, nine staff, three visitors and three health care professionals. People told us positive things about the home. One person said "I am happy and settled here". Another person said "The staff are very kind'.

We saw that staff treated people with dignity and respect. People's needs had been assessed by a range of health professionals including doctors, the community matron and the optician. This meant that people's health care needs had been monitored and met.

We saw that people had been given their medication as it had been prescribed by their doctor and that records of medication administration were maintained. However, we identified that some improvement was needed concerning medication storage, recording and temperature control.

Recruitment processes ensured that staff employed were suitable to work with the people living at the home which protected them from harm.

Records and staff both confirmed that systems had been used to monitor how the home had been run as it was supposed to be.