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Inspection carried out on 19 July 2017

During a routine inspection

Albany Nursing Home is registered to care for up to 61 people with nursing needs and at the time of the inspection there were 59 people using the service. This included younger people with disabilities and older people with varied conditions such as dementia and complex nursing needs. The home is laid out on three floors and accommodation for people is in single rooms, except for one double room.

At the last inspection in March 2015, the service was rated Good. At this inspection we found the service remained Good.

People and relatives felt safe using the service. There were enough suitably qualified staff to meet people’s needs. Safe recruitment checks were made before employing new staff. Staff were knowledgeable about safeguarding and whistleblowing procedures. People had risk assessments done and risk management plans were put in place to ensure they were kept safe while using the service. Building maintenance and equipment checks were up-to-date. Medicines were managed safely.

Staff were supported through regular training opportunities, supervisions and appraisals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff were knowledgeable about what was required of them in line with the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. Staff were aware of how to obtain consent before delivering care. People were offered a variety of food and drink and were supported to access healthcare as required.

People and relatives gave positive feedback about staff. Each person had a named care worker and a named nurse who were responsible for overseeing the care the person received. Staff demonstrated awareness of people’s care needs, respecting people’s privacy and dignity, maintaining independence and equality and diversity needs.

Staff were knowledgeable about providing a personalised care service. Care plans were comprehensive and showed people’s preferences. A variety of activities were offered which included visiting entertainers and trips outside the home. The service kept a record of compliments and complaints made and used these to make further improvements to the care provided.

People, relatives and staff spoke positively about the management of the home. The provider had systems to obtain feedback about the quality of the service and carried out various audit checks on the quality. These systems were used to make improvements to the service. Regular meetings were held with people, relatives and staff to keep them updated on service development and identify issues that needed resolving.

Further information is in the detailed findings below.

Inspection carried out on 6 and 10 March 2015

During a routine inspection

We carried out this unannounced inspection on 6 and 10 March 2015.

We last inspected the home on 15 and 16 April 2014. During this inspection we found breaches to seven regulations. People were not protected against unsafe medicines management because the provider did not have appropriate arrangements in place for handling, using, dispensing and disposal of medicines. The provider had also not ensured premises and equipment were safe and fit for purpose due to inadequate maintenance. We found that standards of cleanliness and hygiene were not maintained to ensure people were protected from the risk of acquiring an infection and effective systems were not in place to assess and monitor the quality of the service and to identify, assess and manage risks. In addition, people were not protected from unsafe or inappropriate care arising from the lack of proper information about them. The provider sent us an action plan stating the steps they would take to address these issues. At this inspection, we found that the provider has taken appropriate action to meet these legal requirements.

Albany Nursing Home is registered to care for up to 61 people with nursing needs and at the time of the inspection there were 57 people using the service. This included younger people with disabilities and older people with varied conditions such as dementia and complex nursing needs. The home is laid out on three floors and accommodation for people is in single rooms, except for one double room.

There was a registered manager at the home. 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.

During this inspection, we found the home provided a safe environment to everybody on the premises. Building maintenance and equipment checks were up to date. Staff were knowledgeable about safeguarding and how to report concerns. Medicines were managed safely. Risk assessments had been carried out and where risks were identified appropriate risk management plans were in place. There were enough staff to meet people’s needs.

Staff received regular training and were knowledgeable about people’s care needs. The manager was aware of their responsibilities around legislation regarding people’s mental capacity. Staff had recently received training in the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. MCA is legislation protecting people who are unable to make decisions for themselves and DoLS apply to people where the state has decided their liberty could be deprived in their own best interests to ensure their safety and welfare. Although most staff were able to tell us what this was, two staff members were unable to tell us what the basic principles were. We were told there were plans to help staff to increase their knowledge and understanding in this area through further training and discussions in supervision and staff meetings.

People had access to healthcare professionals as required to meet their day-to-day health needs. Staff knew the people they were supporting including their preferences to ensure a personalised service was provided. People and their family members were involved in care planning so they could take part in the decision-making about the care they received. There was a range of interactive activities on offer for people to take part in on an individual or group basis to ensure people had their social and emotional needs met. Staff respected people’s privacy and dignity.

The provider had systems to check the quality of the service provided. People and their family members were able to give feedback through satisfaction surveys, the results of which were acted upon to improve the service. People knew how to make a complaint and these were dealt with appropriately. Staff, people, and family members felt comfortable with raising concerns with the manager. Regular meetings were held with staff and for people and their family members so that concerns could be raised and dealt with and updates on the service could be given.

Inspection carried out on 15 and 16 April 2014

During a routine inspection

Albany Nursing Home is a purpose built nursing home. The home is situated in a residential area of Leyton and is close to shops and public transport. The home has three floors each with its own lounge and dining room. On the day we inspected the service had 60 people, of whom 53 were older people some with physical ill health or dementia and seven young physically disabled people. The home is able to accommodate 58 people in single rooms with own or shared en-suite toilets and has one double room with an en-suite toilet.

The service was not ensuring equipment was safely used and suitable for its purpose. We saw staff were using commodes to shower people (a chair that can be used as a toilet or over a toilet). None of the commodes we saw had foot rests, therefore, people were at risk of damaging their feet or legs while being moved in them. These problems were evidence of a breach of a health and social care regulation. You can see what action we have asked the provider to take at the back of this report.

People were not protected from possible infection risks associated with poor cleaning of the environment and equipment they used. Areas of the home were dirty and dusty and equipment aids used by people, including commodes were found to be unclean. These problems were evidence of a breach of a health and social care regulation. You can see what action we have asked the provider to take at the back of this report.

Medicines were not always managed safely. Storage arrangements were not suitable to ensure medicines were kept at the right temperature. Staff were not always recording when they had opened prescribed eye drops, putting people at risk. These problems were evidence of a breach of a health and social care regulation. You can see what action we have asked the provider to take at the back of this report.

Records at the service were not kept up to date or not fully completed, we saw Do Not Attempt Resuscitation (DNAR) forms. These forms record people’s views on resuscitation and some of these had not been completed fully. Records of important meetings such as staff meeting were not kept. Therefore the registered manager and the provider were not ensuring accurate records were kept to protect people against the risk of inappropriate care and treatment. These problems were evidence of a breach of a health and social care regulation. You can see what action we have asked the provider to take at the back of this report.

Most of the people we spoke with felt safe at the service, One person said, “My relative feels safe here,” another said, “Safe, yes staff seem very alert.” However others said, “I feel safe sometimes,” another relative said, “People keep coming into my relative’s room I worry about that.” We received mixed feedback about the care provided to people. Comments included, “I love it here, it’s nice and warm, I’m happy” and “The staff love my friend.” However other people said, “When I shout for help no one pays attention,” and “When I talk, staff interrupt me or ignore me.” We spoke with health professionals who supported people at the service who were positive about the care provided.

Most people we spoke with complained about the lack of activities at the home, one person said, “Nothing to do here, but watch TV, but sometimes it’s too noisy even for that.” While we were inspecting the service we did see people take part in a bowling game and we saw that some ladies had received a manicure from staff.

We saw that the registered manager and the provider did not have effective systems in place to assess and monitor the quality of the service. Audits we reviewed were not effective in identifying issues with medicines, infection control and maintenance of the building. They did not regularly seek the views of people who used the service. These problems were evidence of a breach of a health and social care regulation. You can see what action we have asked the provider to take at the back of this report.

Inspection carried out on 11 July 2013

During a routine inspection

We spoke to four members of staff and six people who used the service and their relatives.

We found the home appeared well-maintained with pleasant decor and several communal and private spaces. We did not find documentary evidence that people and their relatives were involved in planning care, but people we spoke to said they were involved. A relative told us, "They are very good at listening to your opinions" and one person who used the service said "They always tell you what they're doing, but it's your choice."

We observed staff interacting with people and their relatives one-to-one and in group activities. We found evidence of activities being planned within the home and in the community. Care plans and risk assessments took into account people's personal and medical history and were adaptable to reflect people's changing needs.

Visit logs were available to communicate between the home and other providers involved in people's care. One person using the service said "Their communication is good. They have my care completely covered."

The home had a safeguarding policy in place. People we spoke to said they had not received information about how to recognise and report signs of abuse. One relative said "I don't know what I'd do."

People said staff were "brilliant" and "definitely the right people for the job." We found evidence that appropriate checks had been carried out before staff started work.

Inspection carried out on 14 November 2012

During a routine inspection

People told us that the care at Albany was “outstanding”. We spoke to 12 relatives and eight people who used the service. We observed five people living with dementia and found that staff interacted with them positively and responded appropriately to their needs. One person said “I think the staff are wonderful. I don’t know what we would do without them.” Another said “staff are excellent. They are very patient.”

We observed that medicines were administered safely and regular checks were done to make sure there were no dispensing discrepancies. Medicine administration records stated whether people had any medicine allergies.

People told us that staff always gained their consent before they gave care and explained what they were going to do. We observed staff seeking consent before staff proceeded to help people with their needs.

Staff received appropriate development and were appraised regularly. We saw evidence that staff received regular training and had regular staff meetings.

We found that people’s records were up to date and reflected the individual’s current condition. There were risk assessments and care plans were person centred. There was evidence that people were assessed when they were admitted and care was planned and reviewed monthly or earlier if the person’ condition changed

Inspection carried out on 12 October 2011

During a routine inspection

People told us that they are well cared for at the home, that the staff are kind and friendly and the food is good.

Reports under our old system of regulation (including those from before CQC was created)