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Alveston Leys Care Home Good

Reports


Inspection carried out on 19 December 2017

During a routine inspection

This inspection took place on 19 and 20 December 2017. We returned on the 2 January 2018 so we could speak with the registered manager and look at their quality assurance systems.

Alveston Leys Care Home is registered to provide nursing and residential care for up to 60 people. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home has a residential unit and a nursing unit which is spread over three floors. At the time of our inspection visit, 43 people lived at the home.

A requirement of the service’s registration is that they have 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 and the associated Regulations about how the service is run. At the time of our inspection visit there was a registered manager in post who was supported by a deputy manager.

At the last inspection on 7 February 2017, the service was rated as requires improvement. We found a breach of the regulations because improvements were needed in the deployment of staff. We also found improvements were needed in the processes and procedures to support the provision of quality care within the home. Following the last inspection visit, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe and Well led to at least good.

This inspection visit was a comprehensive inspection and during this inspection we checked to make sure improvements had been made. Whilst some improvements had been made, we found improvements were still needed to ensure daily records were accurate and clearly evidenced the care provided.

There were enough staff to provide safe and effective care that met people’s needs. Recruitment procedures ensured staff were qualified and safe to work with people who lived in the home. Staff understood their safeguarding responsibilities and the action they should take if they were concerned a person was at risk of harm.

The provider used a variety of risk assessment tools to identify any potential risks to people’s health and safety and risk management plans guided staff on how to manage those identified risks. However, daily records to support risk management were not being consistently or accurately completed.

Accidents and incidents were recorded by staff and analysed by the registered manager to identify any emerging trends or patterns so appropriate action could be taken to minimise identified risks.

People received care from staff with the knowledge, skills and competencies to support their health needs. Medicines were ordered, received, stored, administered and disposed of in accordance with good practice and overall, staff understood their role and responsibilities in relation to infection control and hygiene.

The provider assessed people’s capacity to make their own decisions if there was a reason to question their capacity. Staff and the registered manager had a good understanding of the Mental Capacity Act. Where possible, they supported people to make their own decisions and sought consent before delivering care and support. Where people’s care plans contained restrictions on their liberty, applications for legal authorisation had been sent to the relevant authorities as required by the legislation.

Staff supported people to eat and drink enough to maintain their health and referred people to other healthcare professionals when a need was identified. Managers and staff worked with other healthcare professionals to ensure people could remain at the home at the end of their life and receive appropriate care and treatment.

Staff were car

Inspection carried out on 7 February 2017

During a routine inspection

The inspection took place on 7 and 14 February 2017 and it was unannounced.

Alveston Leys Care Home provides nursing and personal care for up to 60 older people. On the day of our inspection there were 43 people living in the home. One side of the home was a residential unit and the other side was for people who required nursing care. The nursing unit consisted of three floors. The provider had opened the Lavender Unit in October 2016 for people living with dementia on the ground floor.

The manager had worked at the service since December 2016 and was in the process of completing their registration with CQC. 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. Both the manager and deputy manager had previous experience of managerial roles.

People were happy with the care and support they received at Alveston Leys and found staff to be caring, polite and professional. People told us they had a positive relationship with care staff who knew them well. Staff were committed to providing a friendly, homely environment for people and their visitors. They received the training and support they needed to meet people's needs effectively.

People felt safe living at Alveston Leys and we saw people were comfortable and relaxed in their surroundings. Staff knew what to do if they thought someone was at risk of abuse or avoidable harm. The provider's recruitment process was thorough which meant risks to people's safety from unsuitable staff were minimised.

The managers understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had completed training in the MCA and understood how to support people to make decisions about their daily lives. Where restrictions on people's liberty had been identified, the appropriate applications had been made to the authorising body. People were given choices about how they lived their lives and received support in line with their preferred routines.

Staffing within the home needed improvement. The deployment and management of staff affected the standard and consistency of care people received and meant there were times when there was no staff presence in some areas of the home.

People received food and drink which met their needs. Staff were aware of those people who needed specialist support to maintain their nutritional needs. People were supported to maintain their health and obtain healthcare advice when a need was identified.

People received care that was responsive to their needs and staff understood how they preferred to spend their time. Staff responded to and acted on changes in people’s needs and abilities. People enjoyed the opportunities they had to engage in activities that were of interest to them.

After a period of significant change with staffing and at management level, new staff had been recruited and a new management team were in place. People and staff spoke positively about the new home manager and the deputy manager who shared an enthusiasm to drive through improvements within the service. The new manager was aware that staff morale needed to be improved. They had put processes in place to ensure staff felt listened to and had plans to improve training so staff felt more confident and valued.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 9/10 March 2015

During a routine inspection

The inspection took place on 9 and 10 March 2015 and it was unannounced.

Alveston Leys nursing home provides nursing and personal care for up to 60 older people. On the day of our inspection there were 44 people living in the home.

The home has 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.

People told us they felt safe and would feel at ease to raise any concerns with staff if they needed to. Care and nursing staff knew how to protect people against the risk of abuse and had completed training in safeguarding people so they knew how to recognise abuse and poor practice.

People told us they received their medicines when they needed them. Sometimes the medicine records had not been fully completed to show people had received their medicine but this was being addressed by the manager. People were able to access health professionals such as a GP and district nurses when needed to support their healthcare needs.

People were supported by sufficient numbers of staff who made time for them and did not rush them. The registered manager assessed staffing levels to make sure there was always enough staff to meet the needs of people who lived at the home.

The registered manager had an understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) so that people who lacked capacity to make decisions could be appropriately supported. Some staff were not clear about their responsibilities in relation to these but staff training had been provided and staff understood they needed to gain people’s consent before delivering care.

People were provided with choices of nutritious food that met their needs and there were regular choices of drinks available during the day. Where people needed support to eat this was provided. A range of social activities were provided that were person centred in accordance with people’s interests and wishes.

There was clear leadership within the home and an open culture where staff and people’s opinions about the care and services provided were encouraged and sought. The provider carried out regular checks on the quality of care and services to identify any areas that required improvement.

Inspection carried out on 26 November 2013

During a routine inspection

During our inspection visit to Alveston Leys Nursing Home we spoke with six people who used the service about the care and support that they received. They told us they were happy with their care. Their comments about staff were all complimentary and included, �Marvellous�. We found that staff respected the wishes of people who used the service and got their consent before providing care.

We spoke with three relatives of people who used the service and saw staff welcome and chat with others. They told us that they felt comfortable in the home. A regular visitor was very happy with the care and said staff were ��friendly and caring.��

People who used the service told us they had enjoyed their lunch time meal and we saw staff assisted those people who needed help.

We spoke with six staff and found they were knowledgeable about the needs of people who used the service and their responsibilities. Assessments and care plans identified the care that people needed and guided staff in the delivery of appropriate care.

Medication was safely managed and recruitment checks were sufficiently robust to guard against employing unsuitable staff.

We also spoke with the manager and the area manager. We found that Alveston Leys Nursing Home was well managed with good systems in place to assess and monitor the quality of care.

Inspection carried out on 30 July 2012

During a routine inspection

We spoke with four people using the service, two relatives and six staff including the manager on the day of the visit.

People told us they liked living at the home, felt safe and had been happy with the care and support received. Some comments from people about their experiences at the home were: ��The home is terribly good�� and ��the staff are quite good, I feel safe living here��. People said they liked the food, had a choice of meals and had enough to drink.

People told us their views had been taken into account and should they have any concerns they would talk to a member of staff or the manager. Staff, people using the service and their relatives told us they had been kept informed of changes and developments. They had received this information through attendance at meetings and care reviews. One person described the residents� meetings as ��very friendly affairs�� and topics for discussion had included food and activities offered at the home.

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