Archived: Alexian Brothers Care Centre

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 The fire risk assessment was out of date and some of the radiators were extremely hot and posed a potential risk to people who used the service.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 needed to. The service had received a number of compliments.

People told us the management were approachable and staff felt well supported. Supervisions and team meetings took place on a regular basis.

A number of audits and checks were regularly carried out by the service. Where issues had been identified, we found little evidence that these issues had been addressed.

The service had good links with the local community and worked in partnership with other organisations to share good practice.

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.

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.

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.

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.