Background to this inspection
Updated
24 January 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.
The inspection took place on 18, 19 and 20 October 2016. The inspection was unannounced and carried out by one inspector.
Prior to the inspection, we contacted the local authority commissioning and safeguarding adults teams. We also checked all the information which we had received about the service including notifications which the provider had sent us. Notifications are changes, events or incidents that the provider is legally obliged to tell us about. The submission of notifications is a requirement of the law. They enable us to monitor any trends or concerns within the service.
The provider completed a provider information return (PIR) prior to the inspection. A PIR is a form which asks the provider to give some key information about their service; how it is addressing the five questions and what improvements they plan to make.
We spoke with the provider - Mr and Mrs Leavy, Mrs Leavy was also the registered manager. We also spoke with the home manager, administration manager, deputy manager, two senior care workers, two care workers, the cook and a member of the domestic team/maintenance. We spoke with 10 people and three relatives to obtain their views of the service.
We contacted four doctors, the district nursing team, a solicitor who represented several people who lived at the home and a senior ear care nurse who all responded to our requests for information.
We examined three people’s care plans, staff recruitment files and training information. We also looked at records relating to the management of the service such as audits and health and safety checks.
Updated
24 January 2017
The inspection took place on 18, 19 and 20 October 2016. The inspection was unannounced and carried out by one inspector.
We last visited the service on 14 August 2013 where they met all the regulations we inspected.
Oldfield Bank is a residential care home registered to care for 28 people, some of whom have a dementia related condition. Accommodation is spread over four floors and there is lift access to all levels.
The provider is a husband and wife partnership, Mr and Mrs Leavy. Mrs Leavy was also the registered manager. 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 registered manager was supported by the home manager and the administration manager.
People told us that they felt safe at the service. There were no ongoing safeguarding concerns. Medicines were administered safely. We found the storage of controlled drugs, which require stricter controls, did not meet legal requirements. This was rectified immediately after our inspection.
Checks were carried out to ensure that applicants were suitable to work with vulnerable people. This included obtaining written references and a Disclosure and Barring Service check [DBS]. We saw that staff carried out their duties in a calm unhurried manner and were available to provide emotional support to people.
The premises were clean. Checks and tests had been carried out to ensure that the premises were safe such as electrical and gas safety tests. We noted that the electrical installations certificate stated that installations were unsatisfactory and an electrician was currently addressing the deficits at the time of our inspection.
Staff told us and records confirmed that training, was available. An induction programme was in place. This did not demonstrate how staff were assessed as achieving acceptable levels of competence in all areas of their job role. We have made a recommendation about this.
There was a supervision system in place. Appraisals were not undertaken. The home manager told us that appraisals were undertaken as part of the supervision process. She told us that she would implement a separate appraisal system to ensure that support systems for staff were fully in place.
Staff followed the principles of the Mental Capacity Act 2005. Further improvements were required however, to ensure there was documentary evidence to demonstrate how the requirements of the MCA were met. We have made a recommendation regarding this.
People’s nutritional needs were met and they had access to a range of healthcare services.
Staff were motivated and demonstrated a clear commitment to providing dignified and compassionate care and support.
An activities programme was in place to help meet people's social needs. Several people told us that they would like to go out into the local community more frequently. The registered manager told us that this would be addressed.
There was a complaints procedure in place. None of the people or relatives with whom we spoke raised any complaints about the service.
People, relatives, health and social care professionals and staff were complimentary about the management of the service. One health and social care professional stated, “I would recommend this home to anyone looking for a residential home.”
A number of audits and checks were undertaken. We found however, that the service’s quality assurance system did not highlight the issues which we had identified such as the storage of controlled drugs, the positioning of bed rails, induction training and mental capacity assessments. We have made a recommendation about this.
Staff were very positive about working for the provider. They said they felt valued and enjoyed working at the home. We observed that this positivity was reflected in the care and support which staff provided.