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Allenbrook Nursing Home Good


Inspection carried out on 27 February 2019

During a routine inspection

About the service:

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 f

Inspection carried out on 15 August 2016

During a routine inspection

The inspection took place on the 15 and 16 August 2016 and was unannounced.

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.

Inspection carried out on 7 October 2013

During a routine inspection

People were treated with consideration and respect and their privacy, dignity and independence were maintained. People were able to make choices about their daily life.

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.

Inspection carried out on 16 August 2012

During a routine inspection

People who lived in the home were generally positive about living there. One person told us �It is well organised, staff are excellent, they are so helpful, always there and never let you down�. Another person told us �on the whole people are very nice, very kind�. One person told us that �you get the odd member of staff having an off day�. People we spoke with said that staff were respectful.

One person told us that the �grounds are lovely�. Another person we spoke with said they enjoyed looking out of the bedroom window as they had bird feeders outside because they liked to watch the birds.

The people we spoke with told us that they were not involved in planning their care.

People told us that they were able to choose from two dishes for their main meal and if they did not want either of those choices they could have an omelette. We observed people being offered drinks and biscuits at coffee time. There were facilities for visitors and people who used the service to make drinks for themselves. We observed one person being assisted to eat a meal by a member of staff standing directly in front of them, feeding them whilst the person was sat in a chair in the lounge. One person told us that they were taken into the dining room for dinner but they do not like eating with other the people. They said they had not been asked where they would prefer to eat.

People we spoke with thought that there were enough staff to support their needs. During our visit we observed a clear presence of staff and people had their meals in a timely manner.

During our visit we observed some positive practice but we found that people were not always being respected. There were some concerns about the call bell system but the home took steps to check this following the inspection. The home had effective quality assurance systems and action plans were created to address any issues identified.

Reports under our old system of regulation (including those from before CQC was created)