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Archived: Margaret Allen House Residential Home Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 November 2017

Margaret Allen House is a residential care home for 15 people, including people living with dementia. There are two floors accessed by a passenger lift and the lounge and dining room are based on the ground floor. An unannounced inspection took place on 24 and 30 August 2017. At the time of the inspection, 15 people were living at the home.

When we visited there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like 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. However, during our inspection the registered manager was unavailable. The service was being overseen by a senior manager who was assisted by a team leader from another service. Since the inspection, the team leader has been promoted to manager.

After our inspection, we received information from the provider about a safeguarding alert, which was being investigated.

People living at the home were positive about living at the home and said they would recommend it to others. However, some people said they would like more to do to fill their time. People had good relationships with staff and they said staff were usually kind and caring. There had been some changes in the staff team but people mainly described the staff team as stable. Agency staff were being used to supplement the care team until newly recruited staff had completed their induction. People had not been provided with an opportunity to formally provide feedback on the service in the form of a survey. However, they felt informed about changes relating to the service.

The provider had created a Learning and Development Team that had set up an academy induction which starts staff on the Care Certificate. This ensured all newly recruited staff had received mandatory training before arriving on their first shift. This training took 6.5 days. The whole induction process takes six months once the staff member has completed further training on site in the care home. However, staff did not benefit from regular on-going support such as supervision, team meetings and observation of their practice. Staff morale was described by some team members as low, which they said negatively impacted on how the staff group worked as a team.

People were offered a choice of meals. They were supported with their health needs and had access to health professionals, when necessary. They told us staff respected their privacy and dignity. However, there were occasions when some staff practice undermined people’s privacy.

Staff knew how to recognise and respond to allegations of abuse. During the inspection, we shared feedback with the senior manager about concerns regarding staff practice, which a staff member said had not been managed appropriately. Subsequently the senior manager completed an investigation. Staff confirmed they had been spoken to about their practice but records were not found to corroborate this action. After our inspection, the senior manager completed an unannounced spot check visit to the home to monitor staff practice.

Staffing levels were based on a tool to assess the level of people’s care needs. Changes had been made to increase staffing availability at night in recognition of people’s increased needs. Following feedback during the inspection, the senior manager said the way the afternoon and evening shift was run would be reviewed. It had been identified that the staff rota had been poorly managed resulting in a risk of staff working excessive hours; this rota was now being overseen by senior staff to ensure there was an appropriate mix of staff skills and experience.

Quality assurance reports had highlighted improvements were needed in the running of the service. Care records and staff practice were not reviewed regularly to ensure they were meeting the needs of people. Risks to peo

Inspection areas

Safe

Requires improvement

Updated 14 November 2017

Some aspects of the service were not safe.

There were sufficient numbers of staff on duty to meet people's needs but roles in the afternoon were due to be reviewed.

Improvements had been made to how people�s medicines were managed but the practices needed to be embedded.

Risks to people were being reviewed and action was now taking place to ensure they were managed appropriately.

Staff knew how to recognise and report allegations of abuse.

Staff who worked at the service had undergone a robust recruitment process.

Effective

Requires improvement

Updated 14 November 2017

Some aspects of the service were not effective.

A good range of training was available to staff. However, support and feedback to staff had not occurred on a regular basis and this meant some staff felt unsupported.

Work was taking place to ensure people�s legal rights were being protected by staff who knew their responsibility under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were supported to access healthcare services to meet their needs.

People were supported to maintain a healthy diet.

Caring

Requires improvement

Updated 14 November 2017

Some aspects of the service were not caring.

Some staff practice undermined people�s privacy. People were supported by staff who were usually kind and caring. People were involved in decisions linked to their care and daily life. Staff knew people well and there was a friendly atmosphere.

Responsive

Requires improvement

Updated 14 November 2017

Some aspects of the service were not responsive.

People living at the home identified how arrangements to meet their social needs needed to be improved.

Assessments and care plans were not completed in a consistent manner and were not regularly reviewed.

People were confident their complaints would be listened and acted upon.

Well-led

Requires improvement

Updated 14 November 2017

Some aspects of the service were not well led.

Quality assurance staff regularly visited the home and were committed to improving the service. However, identified shortfalls in the running of the home, which included security improvements and how staff were supported, had not been addressed in a timely way.

People living and working at the home told us there was a friendly atmosphere.