Allenbrook Nursing Home

Allenbrook Nursing Home is a nursing home providing personal and nursing care to up to 43 people. At the time of our inspection there were 37 people using the service. Accommodation at the home is provided over 3 floors. There are large gardens and patio areas which provide a safe and secure private leisure area for people living at the home.

People’s experience of using this service and what we found

People told us they felt safe living at Allenbrook Nursing Home. We received consistent positive feedback from people and their families as well as health professionals. One person told us, “I’m very happy here. I feel safe because they look after me.”

Medicines administration records (MARs) confirmed people had received their medicines as prescribed.

Staff felt well supported and able to approach the manager with any concerns. An action plan was in place to support further development of staff supervision.

People were supported with their nutritional needs and told us how much they enjoyed the food. One person told us, ‘‘I like the food and they work hard on the choice they offer us. They bring the menu around so I can choose what I want.”

Staff had received training in safeguarding adults and knew how to identify and report abuse. There were enough staff to keep people safe.

Staff worked collaboratively with health professionals to support people with their healthcare needs. There was a system in place to enable people and their relatives to express any concerns or complaints they may have.

Relevant recruitment checks were conducted before staff started working at the home to make sure they were of good character and had the necessary skills.

The provider sought feedback on the service it provided, this information and outcomes were used to drive improvement.

Governance systems in place were effective at driving improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was good (published 19 June 2019)

Why we inspected

The inspection was prompted in part due to concerns arising from our review of notifications received from the service. A decision was made for us to inspect and examine those concerns.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Allenbrook Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Allenbrook is a nursing home that was providing personal and nursing care to 35 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

• People told us they felt safe. Staff had up to date training to ensure they knew how to provide safe and effective care. They understood their responsibility to report suspected abuse. There were pre-employment checks for new staff to ensure they were suitable to work in a care setting.

• Staff reported accidents and incidents, and action was taken to keep people safe. People’s individual risks were assessed and managed in consultation with them.

• There were enough staff to provide the care people needed.

• Medicines were stored securely and managed safely. The premises and equipment were well maintained, and the home was clean and tidy.

• Infection prevention and control measures were in place.

• People were happy with their or their loved one’s care and were confident in the abilities of staff. Care was delivered in line with current standards and good practice. Staff were supported through training and regular supervision.

• People’s needs were assessed thoroughly, and care was planned accordingly; this was all kept under review. 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.

• People were as involved as they wished to be in planning their care, which was tailored to their individual needs. Staff had a good understanding of the care people needed.

• People’s dietary needs were met, and people said they were pleased with the quality of the food.

• There were strong links with the GP surgery and other healthcare professionals. People received the medical attention they needed.

• Healthcare professionals praised the service’s approach to end of life care and staff development in relation to this, including the way staff worked with them to promote high standards of palliative care. The home’s palliative care lead delivered in-house training with support from the palliative care team, to develop the expertise and confidence of staff in this area.

• The high standard of palliative care was evident from compliments received from families regarding end of life care and how well they had been supported also.

• The service had routinely gone the extra mile to find out about people’s hobbies and to accommodate these if possible.

• A range of group and individual activities was organised by the service’s activities team. The service had worked with an older people’s activities charity to develop its activities and events. There were links with local organisations to promote meaningful activity and community involvement.

• People and staff were excited about new life-story picture boards for people’s rooms. These were being introduced for people to celebrate and enjoy, and to help staff understand them as people.

• People and visitors said staff treated them and their loved ones kindly. All the interactions we observed were respectful and professional. People’s dignity and independence were respected.

• Many of the staff had worked at the service a long time and had got to know people well.

• Relatives told us they were kept well informed about their loved one and any changes in their health. Visitors were welcome at any time, providing this was acceptable to the person.

• There were clear and effective management, governance and accountability arrangements. People, visitors and staff voiced confidence in the registered manager and the way the service was led. They felt able to raise concerns with the registered manager in the expectation that these would be taken seriously.

• A robust system for monitoring quality included regular audits overseen by the registered manager, and by an independent management company that oversaw the service. Action was taken when any areas for improvement were identified.

The service met the characteristics of good in all areas except for responsive, which was outstanding.

Rating at last inspection:

At the last inspection the service was rated good (September 2016).

Why we inspected:

This a planned inspection based on the previous rating.

For more details, please see the full report, which is on the CQC website at www.cqc.org.uk.

Allenbrook nursing home provides accommodation for persons who require nursing or personal care for up to 43 people. The home has permanent residents but also provides respite care. At the time of our inspection 38 people were living at the home.

The service had a registered manager. 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 registered manager had left the service in August 2015 but had returned in February 2016.

Individual care records were stored electronically and each member of staff carried a personal data terminal to access and update records accordingly.

The provider had systems in place to respond and manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies.

People who were able to talk with us said that they felt safe in the home and if they had any concerns they were confident these would be quickly addressed by the staff or manager

Assessments were undertaken to identify risks to people's wellbeing. Staff were aware of people's individual risks and knew the strategies in place to keep people safe.

The provider operated safe and effective recruitment procedures. There were sufficient numbers of qualified, skilled and experienced staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Training records showed that staff had completed training in a range of areas that reflected their job role.

Staff received training, supervision and were appraised, providing them with appropriate support to carry out their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection applications had been submitted by the managing authority (care home) to the supervisory body (local authority) and had yet to be authorised. The manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

People were involved in their care planning, and staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes, and care plans were routinely reviewed to check they were up to date.

People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed.

People knew who to talk to if they had a complaint. Complaints were passed on to the registered manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.

We received positive feedback from all of the people we spoke with. We spoke with nine people. Everyone told us that people's care needs were met. One person told us they were 'very comfortable, the staff are very helpful and extremely kind. The food is good too.' Another person told us that the home was 'very good, excellent. I cannot complain at all.' People's needs were assessed and they had access to activities.

People were protected against the risk of abuse because staff understood about safeguarding issues and whistle blowing and knew how to report concerns.

The provider undertook sufficient pre-employment checks in order to ensure that staff employed were of good character and had the skills and experience required.