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Ingham Old Hall Care Home Requires improvement

All reports

Inspection report

Date of Inspection: 24 April 2014
Date of Publication: 29 May 2014
Inspection Report published 29 May 2014 PDF

Overview

Inspection carried out on 24 April 2014

During a routine inspection

We conducted this inspection to establish the following about Ingham Old Hall Care Home: Was the service safe? Was it effective? Was it caring? Was it responsive and was it well-led?

Below is a summary of what we found. This summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff supporting them and from reviewing records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Most of the people we spoke with who lived at Ingham Old Hall told us that they felt safe and secure and that staff treated them with respect and dignity. Some people we could not communicate with but we did observe and note how they were treated, how they were looked after and what efforts were made to keep them safe.

People we were able to speak with told us that they knew who to speak to if they didn�t feel safe or were unhappy about something. They indicated that staff took great care to ensure that they felt secure in their surroundings.

We spoke with family members of one person we spoke with. They said "It was a very good admission process. It caused a lot of heartache for us though. We were worried about them not fitting in, but we needn't have worried. Friends were made almost straight away. Staff are excellent too."

We inspected the staff rotas and found that there was sufficient staff on duty to meet people's needs throughout the day and night. The home was clean and maintained to a satisfactory standard. We found that staff were trained and supported to do their job safely.

Ingham Old Hall had a daily programme of identifying and rectifying maintenance requirements. This meant that people were not exposed to unnecessary risk.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards [DoLS] which applies to care services. We reviewed applications up to and including July 2012. No applications had been made since that date. All applications were documented, signed, dated and with witness statements where applicable. Adequate policies and procedures were in place relating to DoLS. Staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

Ingham Old Hall demonstrated that it took great care to ensure the care and wellbeing of the people using the service. This was shown in individual care records, up-to-date and current risk assessments, daily reports and communication records. We saw evidence of people having been involved in decisions about their care, where this was possible, and that their needs and wishes were known.

There was a system of recording and managing incidents concerns and complaints which was managed by the manager. We saw evidence of how the home responded to issues, or requests, which resulted in the home increasing its levels of effectiveness and satisfaction. For example there was an internal policy of replacing worn equipment immediately.

Is the service caring?

Ingham Old Hall operated an �open door� policy to people living at the service, their families and staff. The manager told us "If anyone had any concerns or issues about the care provided, the door was always open to discuss it.�

We noted that people were supported respectfully and courteously. We particularly noted that people were spoken with in a polite manner by staff. Smiles and words of comfort were offered and interactions seen to be understood by the person spoken with.

We saw evidence that care records were reviewed on a monthly basis or more frequently if required. Reviews with people using the service and their family members were also noted to take place. This told us that the home took reasonable steps to work with families to deliver care in a way which was both satisfactory and re-assuring.

Care and support provided was as individual and informative as it could be. We noted that other healthcare professionals worked with the home to ensure continuity of care where necessary.

Was it responsive?

We saw that the home responded to people on an individual basis. People�s likes/dislikes were acted on and we saw every effort made to put the interests and wellbeing of the individual first.

One person we spoke with said �I had to live somewhere and as it turned out, this was the best place for me. It was hard at first but now I'm settled and happy.�

We saw staff responding to people's needs and questions in a proficient manner. We noted that whilst staff were busy that they still took time out to re-assure people, interact with them and generally engage with them.

We saw evidence that staff had individual knowledge of each person and their care requirements, for example, how best to communicate with them, their likes, dislikes, dietary requirements and behavioural challenges. We noted that comments and thoughts were shared in daily records and shared across the management and care teams as part of ongoing reviews.

Was it well-led?

Ingham Old Hall runs and maintains a quality assurance system. The quality assurance system in place was robust. Learning from incidents/complaints was recorded and shared and any shortfalls in service provision put right.

We found that people�s personal care records, and other records kept in the home, were accurate, safe and filed appropriately and securely.

We also noted that management and senior carer staff at Ingham Old Hall had agreed to take part in a regional dementia care coach programme. This illustrated their commitment to service users who were living with dementia.