Background to this inspection
Updated
12 August 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.We inspected the home on 2 June 2015.
The inspection team was made up of an inspector, a pharmacy inspector and an expert by experience. An expert by experience is a person who has personal experience of this type so service. The expert by experience had specific experience of health and social care service with particular expertise in palliative and end of life care.
Before the inspection the provider completed a Provider Information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We looked at all areas of the home including people’s bedrooms with their permission, we looked at care records and associated risk assessments for four people, we observed medication being administered and inspected nine medicine administration records (MAR). We observed a lunchtime period in the dining room and observed people being helped with their meals in their bedrooms. We used the Short Observational Framework for Inspection (SOFI) because there were six people living at the service who were living with dementia. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. During the course of our inspection we spoke with eight people who lived at the service, one relative, eight staff, the registered manager, the two directors and two health care professionals who visited people on the day of our inspection. We also inspected three staff recruitment files and staff training files.
The inspection team consisted of an adult social care inspector, a pharmacy inspector, a specialist professional advisor, whose specialism was in occupational therapy, and an expert by experience who had experience of palliative and end of life care. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before our inspection we reviewed all the information we held about the service. We considered information which had been shared with us by the local authority and clinical commissioning group (CCG) and we had attended regular meetings arranged by the local authority to discuss the progress made by the provider in making improvements to the service. The service had admissions suspended by the local authority and the CCG because of the breaches of regulation found at previous inspections which meant that the service had not met their contractual obligations. The service had also made a voluntary agreement with the Care Quality Commission not to admit people.
Updated
12 August 2015
Ackworth House is a care home providing nursing for up to 43 older people with a physical or sensory impairment. The main building is a converted hotel with four floors. At the rear of the home there is a newer extension over two floors. The home is situated along the beach front in the small seaside town of Filey. We carried out an inspection on 2 June 2015 and it was unannounced. At the time of our visit there were 20 people living at the service.
There was a registered manager working at this service. 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.
At our last comprehensive inspection on 19 August 2014 we identified continued breaches of the Health and Social Care Act 2008 regulations relating to care and welfare, the management of medicines and staffing levels which had been identified at an inspection carried out in January 2014.We also found additional areas of concern in relation to the environment, quality assurance and completion of records. This resulted in action been taken by the Care Quality Commission. We received an action plan from the provider telling us they would make improvements by 31 December 2014. We carried out focused inspections of the service on 5 February 2015 and 10 April 2015 to check the welfare of people who used the service and to check on any improvements made by the provider. Although we saw that the provider had made some improvements they had not completed their identified actions. At this inspection, carried out on 2 June 2015, we found that the provider had continued to make improvements. While further improvements are still required in some areas we found that all previous breaches of the regulations had now been met.
Peoples care plans reflected their care needs and risk assessments were in place. People we spoke with told us that they were well cared for. People’s nutritional needs were met and they were supported at mealtimes when it was needed.
Medicines were now managed safely for people though areas for further improvement were identified.
The home was now clean and the environment had improved though there were areas within the service which still required refurbishment.
Staff had received an induction when they began working for the service and access to training had improved. Plans for supervision were in place but not yet implemented across the whole staff group. Care provided to people was now based on best practice guidance.
People told us that staff were kind to them and we observed that some staff had a good rapport with people.
People were involved in planning their own care and we found people’s end of life wishes had been recorded. Reviews were carried out by the staff and people had been involved in any reviews their care. There had been no complaints since the last inspection.
We saw that there were still very few activities organised which meant that there was a risk of social isolation for some people.
People told us that they felt the leadership of the service had improved since the last inspection by CQC. Audits and other checks were now in place but needed further time to demonstrate impact on the safety and quality of the service.