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Archived: Alexian Brothers Care Centre Requires improvement

The provider of this service changed - see new profile

We are carrying out a review of quality at Alexian Brothers Care Centre. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 16 February 2017

During a routine inspection

The unannounced inspection took place on 16 February 2017 and had been brought forward due to some concerning information received.

The Alexian Brothers Care Centre is a 74 bedded care home, providing long-term care for older people who require residential support and nursing care. The home is set within mature grounds, in a secure, gated development. On the day of the inspection there were 68 people using the service.

There was a registered manager in place 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.

The last inspection was undertaken in March 2015 when the service was rated as Good overall. During this inspection we found four breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 with regard to safe care and treatment, dignity and respect, complaints and good governance.

You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe at the home and we found the building and grounds to be secure.

Safeguarding policy and procedures were in place and staff were being given extra support in the area of safeguarding to help ensure timely reporting of incidents. Staffing levels were sufficient to meet the needs of the people who used the service. Staff were recruited safely through a robust recruitment programme. There was a robust induction programme and a comprehensive programme of training for all staff.

Medicines systems were robust and safe. Oxygen cylinders were not always used and/or stored safely. The fire risk assessment was out of date and some of the radiators were extremely hot and posed a potential risk to people who used the service. The registered manager agreed to ensure a new fire risk assessment was implemented. Radiator covers were installed immediately to the affected radiators. Water temperatures were tested and some were found to be very hot, presenting the risk of scalding to people who used the service.

The environment was cluttered in places and a number of notices made the environment feel clinical. The premises could have been enhanced with fewer notices, more dementia friendly signage and better lighting to help people orientate around the home.

We observed the mealtime experience on two of the units. Although there could have been some improvements to how the tables were set, we saw that staff were attentive and assisted people respectfully when needed. People told us they enjoyed the food and were given plenty choice. Food and fluid charts were not all completed as required.

The home was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). However, recording of capacity could have been improved.

People who used the service, and their relatives, were positive about the kindness shown by staff. We observed friendly and respectful interactions throughout the day.

We saw a few instances throughout the day where people’s dignity had been compromised. Confidentiality was also compromised by people’s personal records being kept outside people’s rooms where any visitor to the service could potentially view them.

People who used the service felt the staff were responsive to their needs and they were given choice, though some felt staff rushed them.

There were a range of activities on offer. People from the community joined in the mass at the chapel, attended the lunch club and used the hair salon. This gave people in the home the opportunity to mix with people from the locality.

No evidence was available to show that complaints were responded to appropriately. People told us they would be able to raise an issue if they need

Inspection carried out on 28 August 2014

During an inspection to make sure that the improvements required had been made

A pharmacist inspector from the Care Quality Commission visited the home in June 2014 to check whether improvements had been made and maintained. We saw that some improvements had been made but people were still not protected against the risks associated with the unsafe management of medicines.We issued a Warning Notice after our visit in June to make sure that the home made rapid improvements in the safe handling of medicines.

Is the service safe?

We found some areas of the home the service was not safe because people were not fully protected against the risks associated with the unsafe use and management of medicines.

Medicines were not always administered safely to people. The records about the management of medicines did not always show that medicines were handled safely.

Inspection carried out on 10 March 2015

During a routine inspection

This inspection took place on 10 March 2015 and was unannounced which meant the provider and staff did not know in advance we were visiting. The last full inspection took place on 02 September 2013 during which we found the service was not meeting the requirements in relation to regulations we looked at concerning the management of medicines.

We followed this up on 20 January 2014 and again with a pharmacist inspector on 28 August 2014 where we found improvements had been made.

The Alexian Brothers Care Centre is a 74 bedded care home, providing long-term care for older people who require residential support and nursing care. At the time of our visit there were 73 people residing at the home. Care is provided over three floors and attached to the home is a chapel which is used by people living at the home and the local community.

The home is required to have a registered manager. At the time of our inspection there was a registered manager who had been in post since 2010. 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.

The manager was aware of their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager was also aware of the recent Supreme court ruling in relation to DoLS. The Deprivation of Liberty Safeguards aim to make sure that people in care homes are looked after in a way that does not inappropriately restrict their freedom.

There were systems in place designed to keep people safe such as safeguarding policies and procedures and risk assessments in relation to falls, moving and handling and nutrition. We spoke with staff and found they had a good understanding of safeguarding and whistleblowing procedures which are designed to keep people safe. The registered manager had kept us informed of safeguarding incidents and other notifiable events which had occurred in the home in line with their statutory obligations.

We found some areas of the home were in need of redecoration and corridors in bathroom areas needed to be kept free of clutter.

We found the home to be exceptionally well led with a strong emphasis on providing a high standard of person centred care. This was evident throughout the home.

Inspection carried out on 16, 17 June 2014

During an inspection to make sure that the improvements required had been made

We visited this service on 16th and 17th June 2014 to follow up on outstanding compliance actions relating to medication. We had visited the home in September 2013 and January 2014 and found some concerns about the safe handling of medicines. After our visits the provider wrote to tell us how they would improve the way medicines were handled in the home.

The inspection was carried out by a pharmacist inspector from the Care Quality Commission to check whether improvements had been made and maintained. We looked at how medicines were handled on both of the nursing units. We saw that some improvements had been made. However we found people were still not protected against the risks associated with the unsafe management of medicines.

We looked at one of the five key questions we always ask on Inspection. Is the service safe? Is the service effective? Is the service well led? Is the service caring? Is the service responsive?

Is the service safe?

We found the service was not safe because people were not protected against the risks associated with the unsafe use and management of medicines.

People did not always have an adequate supply of their medicines so they could not have their prescribed doses. Medicines were not always administered safely to people.The records about the management of medicines did not show that medicines were handled safely.

Inspection carried out on 20 January 2014

During an inspection to make sure that the improvements required had been made

During the inspection we spoke with the registered manager, a nurse, a senior care worker and one of the unit managers. They told us about the systems in thay had put in place for managing medicines.

We did not speak to people about their medicines during this visit.

We found that some improvements had been made in medicines management since our last visit. However they were not enough to ensure that people were fully protected against the risks associated with the unsafe management of medicines.

Inspection carried out on 2 September 2013

During a routine inspection

During the inspection, we spoke with two visitors and one person was using the services. They told us they were happy with the care being provided and felt that people were well looked after. One visitor said “Care is fantastic, no faults”.

They told us they regularly took part in activities, when possible and everyone felt there was a choice of food and drink.

We found that people were asked for consent and the provider acted in accordance with peoples’ wishes. People who use the service received care in a way that met their needs and preferences.

The people we spoke with told us they felt the home was clean and safe. One visitor told us “The room is fantastic, couldn’t choose a better one”.

They told us the staff were friendly and helpful. They also told us they had no concerns about the services they received and were confident they could speak to the staff if they had any concerns. One visitor said “I feet the people are safe here and the staff are very approachable”.

The majority of people had assistance with their medications. The people we spoke with were generally happy with how medications were administered. One visitor told us “My mum has difficulty with medication but the staff manage to get it down her”.

People were cared for by staff that had been through the appropriate recruitment checks. There was an effective complaints system available, in case anyone wished to raise a complaint.

Inspection carried out on 1 October 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at his home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission inspector joined by an expert by experience - a person who has experience of using this type of service and who can provide that perspective.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

The people who used the service said that their wishes were respected in terms of personal care and they were happy with the way they were looked after. People we spoke with were mostly positive about the meals, although one person did say there was not a lot of choice available. Their comments included:

"The staff are always very discreet when they help me with my personal care".

"People are around if we need them."

"I have never been spoken to badly, the staff are all lovely and very kind."

We spoke to some relatives of the people who used the service. They said they were happy with the care provided. Their comments included:

"My relative's key worker is a gem. I am 150% happy with everything and the staff take all my worries away."

"The meals are very very good."

"The staff treat my wife beautifully. She can have a joke with them, they are all lovely."

Health care professionals spoke highly of the home and said staff were aware of people's care needs and followed their guidance correctly. They said staff made appropriate referrals to ensure people received the right level of care. They said the staff were receptive to training and sought advice and guidance appropriately.

Inspection carried out on 27 July 2011

During an inspection in response to concerns

People using the service told us during our visit on the 28th July 2011 that they enjoyed living at the Alexian Brothers Care Centre. People said the the care workers were "very caring " and “I am very happy with everything, its lovely".

People told us that they enjoyed their meals and were offered choices, but one person said they sometimes had to " wait a long time at the table before they were served their meal".