• Care Home
  • Care home

Archived: The Albany Care Home

Overall: Good read more about inspection ratings

7 London Road, Headington, Oxford, Oxfordshire, OX3 7SN (01865) 565028

Provided and run by:
Four Seasons (Bamford) Limited

Important: The provider of this service changed. See new profile
Important: The provider of this service changed. See old profile

All Inspections

27 May 2015

During a routine inspection

We inspected The Albany Care Home on 27 May 2015. The Albany Care Home provides residential and nursing care for people with a range of conditions, this incudes people living with dementia. The home offers a service for up to 48 people. At the time of our visit 25 people were using the service. This was an unannounced inspection.

At previous inspections of this service on 9 October 2014 and 7 January 2015 we found the provider did not have effective systems in place to monitor the quality of service. In addition we found medicines were not being managed safely and people were not always receiving care in line with their care plans. People did not always receive food and nutrition to meet their needs.

At this inspection, in May 2015, we found the provider had taken action to address the areas of concern and bring the service up to the required standards.

There was a registered manager in post. 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 2008and associated Regulations about how the service is run.

People, their representatives and staff spoke positively about improvements made to the service and about the registered manager. The registered manager and deputy manager had introduced improved systems to monitor the quality of service. This included systems to monitor the management of medicines to ensure people received their medicines safely.  

People's needs had been assessed and where risks were identified risk assessments were in place. People were involved in developing their care plans. Staff were knowledgeable about people's needs and provided care in line with care plans.

The registered manager had introduced effective quality assurance systems to enable the monitoring and improvement of the service.

The Registered Manger had recruited permanent nursing staff and were no longer using agency nurses. This had improved the continuity of nursing care.

People were supported by staff who were kind and caring. The atmosphere during our inspection was cheerful and calm. People enjoyed the activities, engaging in positive interactions with each other and with staff. We saw lots of laughter and enjoyment.

Staff felt supported and were complimentary about the registered manager and deputy manager. Staff had access to development opportunities.

The registered manager was engaging with the local community. A celebration for 'care home open day' had been arranged and people from the local community invited.

The provider was adhering to the principles of the Mental Capacity Act 2005 Code of Practice. The Mental Capacity Act 2005 ensures that where people lack the capacity to make decisions, any decisions made on the person's behalf are made in their best interest.

7 January 2015

During an inspection of this service

7 January 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection on 24 July 2014 and 9 October 2014. During this inspection we found breaches of legal requirements.  As a result we undertook a focused inspection on 7 January 2015 to follow up on whether action had been taken to meet legal requirements.

You can read a summary of our findings from both inspections below.

Comprehensive Inspection 24 July and 9 October 2014

This inspection took place on the 24 July and 9 October 2014. We decided to carry out a second visit as part of this inspection as serious concerns had been raised with us following the first visit. Both visits to the home were unannounced.

The Albany Care home is situated in Headington near Oxford city centre. The home is registered to provide accommodation, nursing and personal care for up to 48 older people.

The registered manager left on the 4 August 2014 and a new manager started working in the home on the 6 August 2014 and had not yet applied to be registered 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 and associated Regulations about how the service is run.

On the first day of the inspection we did not identify any breaches of regulations however we then received information of concern relating to the care and welfare of people living in the home.

Five registered nurses had left since August 2014. At the time of this inspection agency nurses were being used to cover the shortfall as there were no permanent registered nurses working in the home. The provider had voluntarily agreed not to take on any new admissions until registered nurses had been recruited and improvements have been made to the delivery of care for people.

The provider had reviewed the staffing arrangements since July 2014 to reduce the risks to people due to the lack of permanent registered nurses. There were 29 people in the home some with complex health care needs. The provider had ensured there were two registered agency nurses on duty at all times. The provider had also increased the care staff by one care worker per shift, to assist the agency nurses with getting to know the people living in the home.

People were not always receiving their medicines as prescribed and at the time they needed them. Systems for ordering and checking medicines were not robust. Some medicines were not available and there were some surplus to requirements which had not been destroyed appropriately. The high dependency on agency nurses had a negative impact on how people’s health care needs were being met. This included prompt updating of care plans, delivery of care and treatment, safe medicines management and day to day management of the care staff.

People were not always involved in making decisions about their care or treated in a respectful and dignified manner. Staff were not consistent in how they supported and cared for people.

Whilst the majority of the home was clean, well-furnished and free from odour. The treatment room was not clean, was cluttered and there were some risks in relation to the storage of laundry. This meant that not all risks relating to infection control had been reduced.

Staff had received some training in safeguarding, health and safety, moving and handling and keeping people safe. However, staff had not received training in meeting people’s individual needs such as dementia, Parkinson’s, diabetes or pressure area care. This meant staff were not always aware of how the person’s condition could impact on their life. Staff annual appraisals and supervision were not taking place to support good practice as there were no registered nurses employed to take on this responsibility.

There was a lack of leadership for care workers as a result of the absence of permanent registered nurses who could guide and direct them on each shift. The provider had developed an action plan to reduce some of the risks to people and support the care staff. This included ensuring there was senior management presence seven days a week including a clinical facilitator and a peripatetic manager. This had been put in place the week before the inspection carried out on the 9 October 2014 and roles were still being embedded.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Focused inspection 7 January 2015

Following our inspection of 24 July and 9 October 2014 the provider was asked to take action to meet the requirements of the regulations. The provider sent us an action plan and advised us they would comply with the regulations by 31 December 2014.

This was an unannounced follow up inspection to ensure the provider had taken action to meet legal requirements.

The manager of the home had applied to become the registered manager and was awaiting their interview date.

We found the provider had made some improvements. However, there were still concerns that people were not receiving a service that protected their care and welfare.

Management of medicines had improved. There was a new storage area for medicines with hand washing facilities. Systems for managing stock had improved and appropriate quantities were now stored. However, there were still errors in stock balances which meant the provider could not be sure people received their medicines. Not all 'as required medicines' (PRN) had clear instructions relating to when they should be administered.

People's medical conditions were monitored regularly and recorded accurately. However some people did not always receive care as detailed in their care record.

Staff had a clear understanding of The Mental Capacity Act 2005 and supported people to make choices and involved them in decisions about their care.

Staff felt well supported and had received regular supervision. There was use of regular agency staff and the provider continued to recruit permanent nursing staff.

The provider was not monitoring the quality of service effectively. Audits had been introduced, however the audits had not identified the issues highlighted during this inspection.

We found a number breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report. 

24 July 2014 and 9 October 2014

During a routine inspection

This inspection took place on the 24 July and 9 October 2014. We decided to carry out a second visit as part of this inspection as serious concerns had been raised with us following the first visit. Both visits to the home were unannounced.

The Albany Care home is situated in Headington near Oxford city centre. The home is registered to provide accommodation, nursing and personal care for up to 48 older people.

The registered manager left on the 4 August 2014 and a new manager started working in the home on the 6 August 2014 and had not yet applied to be registered 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 and associated Regulations about how the service is run.

On the first day of the inspection we did not identify any breaches of regulations however we then received information of concern relating to the care and welfare of people living in the home.

Five registered nurses had left since August 2014. At the time of this inspection agency nurses were being used to cover the shortfall as there were no permanent registered nurses working in the home. The provider had voluntarily agreed not to take on any new admissions until registered nurses had been recruited and improvements have been made to the delivery of care for people.

The provider had reviewed the staffing arrangements since July 2014 to reduce the risks to people due to the lack of permanent registered nurses. There were 29 people in the home some with complex health care needs. The provider had ensured there were two registered agency nurses on duty at all times. The provider had also increased the care staff by one care worker per shift, to assist the agency nurses with getting to know the people living in the home.

People were not always receiving their medicines as prescribed and at the time they needed them. Systems for ordering and checking medicines were not robust. Some medicines were not available and there were some surplus to requirements which had not been destroyed appropriately. The high dependency on agency nurses had a negative impact on how people’s health care needs were being met. This included prompt updating of care plans, delivery of care and treatment, safe medicines management and day to day management of the care staff.

People were not always involved in making decisions about their care or treated in a respectful and dignified manner. Staff were not consistent in how they supported and cared for people.

Whilst the majority of the home was clean, well-furnished and free from odour. The treatment room was not clean, was cluttered and there were some risks in relation to the storage of laundry. This meant that not all risks relating to infection control had been reduced.

Staff had received some training in safeguarding, health and safety, moving and handling and keeping people safe. However, staff had not received training in meeting people’s individual needs such as dementia, Parkinson’s, diabetes or pressure area care. This meant staff were not always aware of how the person’s condition could impact on their life. Staff annual appraisals and supervision were not taking place to support good practice as there were no registered nurses employed to take on this responsibility.

There was a lack of leadership for care workers as a result of the absence of permanent registered nurses who could guide and direct them on each shift. The provider had developed an action plan to reduce some of the risks to people and support the care staff. This included ensuring there was senior management presence seven days a week including a clinical facilitator and a peripatetic manager. This had been put in place the week before the inspection carried out on the 9 October 2014 and roles were still being embedded.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

10 July 2013

During a routine inspection

We found that care plans and assessments contained detailed information about people's preferences and choices. One person told us 'I was in hospital but they told me about everything'. One relative we spoke with told us 'I was very impressed with the trouble they took to sort everything before my father moved, everything was fully discussed with us first'.

We found people received care in a way they preferred. One person told us "the care here is very good, I am jolly well looked after, if I want anything I only have to ask the staff here'. A relative told us 'the staff here are so good, very friendly, they are very good with my wife, and Four Seasons have really turned this home around'.

We found people were supported by sufficient skilled and experienced staff. A relative we spoke with told us 'the staffing and level of care here seems more professional than other homes I have been to'. One person told us, 'The staff here are wonderful they respond very quickly if you have any health needs, I press my bell and they come running'.

We found the service had quality assurance methods in place, which involved people, to make sure they maintained and enhanced the quality of the service they were providing.

5 July 2012

During an inspection in response to concerns

We spoke to a number of people using the service. All those we spoke to expressed a good level of satisfaction with it. One person who had lived there for a number of years told us that the service had greatly improved since it was taken over by the current managers in 2011. The person said that regular meetings with people using the service had been introduced. They also told us that the manager was often out and around the home checking how care was being provided to people.

One person told us that they had been provided with additional support to help them make the transition from hospital to the home. They said their room was comfortable, the food was 'decent', staff responded promptly when the call bell was activated.

Another person told us they had chosen the home because they had stayed there on previous occasions. They said there were always a lot of activities on offer.