Albert House Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm. At the last assessment, we found safe care and treatment was not always provided because risks to people were not always assessed and managed. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall, the provider had a positive culture of safety; however, lessons were not always learnt to identify and embed good practice. Processes were in place to identify and record accidents, incidents and complaints. A falls analysis was completed by the management team to identify trends and patterns in relation to falls; however, this analysis was not completed for all types of incidents. We identified one incident where a person had left the service without support. Not all appropriate actions had been taken in response to prevent a recurrence, and CQC had not been notified, as required. Despite this, staff told us incidents were generally well managed. They were familiar with procedures for reporting and recording and told us incidents were discussed in meetings. However, these discussions were not always well documented. People and their relatives told us they felt comfortable raising any concerns with staff. One person said, “They do listen and respond to me, absolutely.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People and their relatives told us people were supported to attend appointments, and health professionals were involved in their care as necessary. The service had procedures in place to support staff with new referrals and when working with other professionals. People were assessed to ensure the service could meet their needs prior to admission. One relative said, “Albert House have moved heaven and earth to ensure that [person] is settled.” Health professionals we contacted told us they had good communication and positive working relationships with the service, which supported continuity of care for people. One health professional said, “The home communicates well with relatives and outside agencies especially primary care and, where appropriate community nursing, physiotherapy, occupational therapy and other agencies.”

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider did not always work well with people to understand and manage risks. Systems were in place to identify, assess, and manage risks to people. Improvements had been made and sustained to manage risks related to swallowing difficulties. These risks were assessed and monitored for any changes in needs, with appropriate referrals made to the speech and language therapy team. However, we also identified some individual risks had not been sufficiently assessed. For example, risks for people prescribed anticoagulants, a person at risk of leaving the service unsupported, and catheter care. People and their relatives told us they felt risks were sufficiently managed. Records showed care plans were regularly reviewed and most people or their relatives told us they were involved in the process. One relative said, “The care plan is reviewed, and I can check it on the app.” We observed a calm and supportive environment, where people were encouraged to move about the service independently. Staff knew people well and demonstrated an understanding of people’s risks. They told us care records were improving and contained sufficient information. A staff member said, “Most of them are good enough, they [managers] will update it, they say in handover and explain there have been changes.” Another staff member said, “We are getting better with catheter documentation.” The service encouraged people to take positive risks, such as administering their own medication, daytrips, and assisting people to maintain their mobility. The provider responded promptly to update risk assessments where shortfalls were identified.

The provider had systems in place to detect and manage potential risks within the care environment. People using the service, their relatives, and staff told us they were satisfied with the service environment. However, we identified some shortfalls in the management of environmental risks. For example, information held in the emergency grab bag was not up to date for staff to use effectively in the event of an emergency. The service had a dedicated member of staff responsible for overseeing maintenance. We found most areas of the service were clean and well maintained; however, we noted some areas were cluttered or in need of redecoration and repair. Whilst the risk of burns from radiators had been assessed by the provider, the assessment was not comprehensive and required further action by the provider. We raised these issues with the management team, and during the assessment the provider took prompt action to address them. Other documents we reviewed related to fire safety and health and safety checks, were satisfactory.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The service was clean and free of malodours. People and their relatives told us the service was regularly cleaned and staff used personal protective equipment (PPE) appropriately. One person said, “My room is cleaned every day, the carers wear gloves and aprons.” An infection prevention and control policy reflected national guidance. We were assured the provider was taking appropriate steps to protect people, staff, and visitors from the risk of infection.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Systems ensured people received their medicine as prescribed. People and their relatives told us they were satisfied with the support provided with medicines. One person said, “I get my medication on time, each time they tell me what it is and why I need to take it.” A relative said, “Staff give him his medication, it is paracetamol for pain relief, they make sure that he takes them.” Medicines were stored securely. We reviewed medicines administration records for some people and found the recorded stock levels matched the medicines in place. Protocols were available to guide staff in the use of topical medicines and those prescribed PRN ‘as required’. Where people administered their own medicines, appropriate risk assessments had been completed. Staff responsible for administering medicines had completed training and had their competency assessed. However, we found that not all competency assessments had been updated within the past year, in line with national guidance. One staff member told us, “I have medication training and a refresher each year.” We noted a couple of instances where the date of opening on topical medicines had not been recorded in line with procedure. During the assessment, the provider took prompt action to address these points.