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Ingham Old Hall Care Home Requires improvement

All reports

Inspection report

Date of Inspection: 2 February 2012
Date of Publication: 18 April 2012
Inspection Report published 18 April 2012 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Not met this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

Our judgement

The service is not compliant with this outcome. Improvements are needed.

People using the service do not always receive effective care and support that meets their needs and promotes their health and welfare.

User experience

People with whom we spoke told us that they had their needs met but staff were very busy and it could take a while for staff to respond when called. Another person told us that staff were very good and that they felt well treated. People with whom we spoke were generally satisfied with their care and said they liked living in the home.

The home accommodates a number of people who have some degree of cognitive impairment. Where people were unable to verbally communicate their views about the service, we made observations of their response to staff and way in which they were being supported.

Other evidence

During our visit we looked at the care records relating to some people using the service and crosschecked what it said in the records with the observations we made of those people engaged in their routines of daily life.

We found that the quality of the information in the records was variable and did not always accurately reflect people’s needs. Care plans and assessments had been reviewed monthly, but had not in all cases been up dated with new information when people’s needs had changed. There were inconsistencies in the information in some records which meant that staff would not have clear and accurate information about what people’s needs were and how they should be met. For instance, in the records for one person there was a nutritional needs assessment which stated the person had ‘normal food intake’ and was at ‘low risk’. In another record for the same person, entitled ‘personal assessment’, it stated that the person needed supervising with their meals and liked bite size pieces and finger foods. In another record, for the same person, relating to diet it stated that the person needed encouragement with their food and they were at risk. We observed this person at mealtime and found that they were given a full meal of chicken pie, carrots, cabbage and mash potato. They were not given any assistance with the meal and tried to pick up the food from the plate with their fingers. This went on for over an hour by which time the meal was cold. Their food was not presented in way that they were able to manage independently as set out in one of the plans of care.

When we made observations of the mealtime experience we noted that there were several people who did not receive appropriate support with their meal or the food was not presented in a way that they could manage independently. However, we looked in the records for these people and their weights were being monitored monthly. Most people were maintaining their weight and where issues with weight loss were identified, appropriate advice had been sought.

Risk assessments relating to people’s health needs had been completed but were not necessarily accurate or followed up with a clear plan about how the risks should be minimised. For instance, one person was assessed as being at high risk of pressure sores and there was an entry in the records stating that they had a ‘broken spot on buttocks.’ There was no care plan setting out how the pressure area should be dealt with to prevent it from becoming worse and there was no evidence that advice had been sought from other health professionals.

In some of the records we found information about people’s likes and dislikes along with some life history information. This is particularly important when providing care for people with cognitive impairments. However, the information was very brief and therefore other records of care lacked a person centred approach. For instance, a care plan for social and leisure stated that the person had dementia and did not get involved with activities as they cannot comprehend. We observed this person and they were able to engage with staff on a one to one and an entry, made by staff, in another record said they would look at magazines and papers.