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Inspection report

Date of Inspection: 28 February 2014
Date of Publication: 22 March 2014
Inspection Report published 22 March 2014 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 28 February 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members and talked with staff.

Our judgement

There were not enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

There were not enough qualified, skilled and experienced staff to meet people’s needs.

Prior to our visit we had received information advising us there were not enough staff on duty to meet people’s needs. We had also received information from a ‘whistleblower’ (this is a term that is widely used when a current or former member of staff raises a concern about their place of work). The concerns we received detailed information about a memo that had been addressed to all nurses and carers at the home, from the registered manager, requesting them not to not complain to the Care Quality Commission about staffing levels.

The accommodation at Astley Grange was arranged over three floors. At the time of our visit there were eight people living on the lower floor, 10 on the middle floor and 11 people accommodated on the top floor. There were two care workers allocated to each floor and one nurse working between the middle and lower floor where nursing care was provided.

We spent time on each floor and saw staff were busy throughout our visit. On the middle floor nine of the 10 people required two members of staff to meet their moving and handling and personal care needs. We saw people having to wait for staff attention. These were some examples: One person told us they liked to get up at 9:30am but hadn’t been able to get up that morning until 11:45am because the care workers were busy. One person wanted to go and lie on their bed before lunch, but had to wait as one of the care workers was on their break. One person asked us for assistance with a drink, the two staff on duty were busy assisting someone to get up. This meant the person had to wait. At 11:30 am one care worker was serving hot drinks, they then were called away to attend to someone’s personal care needs so people were left waiting for their hot drink.

On the lower floor staff told us six of the eight people needed the assistance of two care workers to meet their moving and handling and personal care needs. Again we saw people having to wait for staff attention. At 11:50am the two care workers were assisting one person to get up. Another person was asking for the toilet but no staff were available. This person had to wait 10 minutes for staff to attend to their needs.

One person told us they were fed up with having to wait for staff to attend to their needs. They also told us they were reluctant to say anything “As they take it out on you.” The same person told us when we spoke with them at 11:15am that they hadn’t had a wash that morning or had their teeth cleaned.

We spoke to some relatives who told us they felt the staffing levels were too low. On relative told us their family member sometimes looked unkempt when they visited.

People told us generally that staff were nice but there just weren’t enough of them. Three people told us when they used their emergency buzzer it could take up to 10 minutes for staff to attend to their needs.

One person told us they like to get up before the night staff go home. They told us this had not been possible on some mornings as there had not been enough staff on duty. We looked at the duty rota, signing in book and handover sheets and saw there had been three occasions during February 2014 when only three members of staff had been on duty instead of four. The manager told us this had been due to staff not turning up and them not being able to find cover.

We showed the provider the copy of the ‘Memo’ we had received and discussed our concerns about the content. We also showed the ‘Memo’ to the registered manager who told us they had put a memo up in the staff room about staffing levels, but that our copy had been ‘tampered’ with. The provider informed us they would be investigating these particular issues further following our visit.