Archived: Altham Care Home

We considered the evidence we had gathered under the outcomes we inspected. We spoke with nine people using the service, looked at care records of two people in detail and a selection of other records in relation to other people's care. We also spoke to four staff on duty, looked at three staff files and spoke with the registered managers and directors.

This is a summary of what we found:

Is the service safe?

Before people were admitted to the home they had an assessment of their needs. This helped to make sure they would be safe in the environment and there was enough skilled and qualified staff to meet their needs.

The managers understood their obligation to apply the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). This is a legal framework designed to protect the best interests of people who are unable to make their own decisions.

There were no unnecessary rules or restrictive practices in place at the service.

People told us they were treated with respect and dignity by the staff. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Risk assessments were completed and staff had been made aware of who may be at risk of falling, developing pressure ulcers or may not eat enough. Staff had guidance on how to manage these risks.

Staff were trained in emergency procedures such as fire and first aid. All staff had been trained in safe moving and handling people and this was up to date.

We found appropriate arrangements were in place in relation to the safe storage, receipt, administration and disposal of medicines. People told us they received their medicines when they needed them.

Recruitment procedures adequately protected people using the service; because relevant character checks had been conducted before new staff provided care and support to people. Staff contractual arrangements prevented them from gaining financially from people they cared for.

We found the provider has taken steps to provide care in an environment that was safe. Health and safety checks were carried out at regular intervals and all essential services such as fire, gas, electric and water were certified as being safe. Safety locks were fitted as standard on bedroom doors and security arrangements at the home were good.

Systems were in place to make sure the provider continually checked the service was safe. This reduced the risks to people and helped the service to continually improve.

Is the service caring?

People told us they were happy with the care they received and the staff team. They said, 'The staff are great. It's a case of treat others as you would like to be treated and do as you would have done to you. They help me in bed and if I use my call bell they come straight away.' 'Staff help me even during the night. I worry about things and I like to stay in my room. I'm not very confident having a shower, but the staff help me have an all over wash every day.' 'I can do most things for myself. My problem is I can't see very well. The staff are lovely, they help me as much as I need.'

We saw staff treating people with respect and kindness while delivering appropriate levels of care and support. They were attentive to people's needs and provided one to one support when this was needed. Staff engaged well with people and involved them in activities. Activities were wide ranging.

Staff worked to care plans that were person centred, and sufficiently detailed on how best to meet individual needs. Daily records showed staff responded to people's needs as required day and night. Staff showed an understanding of the varying needs of different people we had discussed with them.

Is the service responsive?

People were given opportunities to say what they wanted. People's assessment of needs and care plans were reviewed regularly and specialist support from health and social care specialists was sought when needed.

A system was in place for receiving comments, compliments and complaints. People told us that they would know how to make a complaint, should they need to do so.

Specialist training was provided for staff such as end of life care and dementia.

Is the service effective?

People told us they were happy with their care. They had their own preferred routines, likes and dislikes staff knew about.

People's health and well-being was monitored and appropriate advice and support had been sought in response to changes in their condition. The service had good links with other health care professionals to make sure people received prompt, co-ordinated and effective care.

People told us they were consulted with and listened to. We were told, 'The managers are quite sociable and will chat to you.' And 'I do worry sometimes when I have to raise any issue. This morning the manager was very affable. I did have an issue, but this was dealt with. Overall I am quite happy. If things are not right staff are good listeners and they will explain things to me.'

There were no institutional practices imposed on people and staff were flexible in their work to accommodate individual needs and preferences.

Is the service well led?

People told us the management of the service was good. One person said, 'She's (manager) always around chatting to us. We talk about different things and I can say what I want. I think everyone works hard and if I was unhappy about the service I would say. Whatever we want we get. There is always plenty going on.'

Staff were clear about their responsibilities and duty of care and were able to raise their views and concerns. Staff were encouraged to develop their skills and knowledge. Training was provided and staff were given opportunity to put their new skills into practice.

There were systems in place to regularly assess and monitor how the home was managed and to monitor the quality of the service. We saw evidence the service knew when to consult with health and social care professionals when required. This meant any decision about people's care and support was made by the appropriate staff at the appropriate level.

The service had achieved Investors In People (IIP) award. This is an external accredited award for providers who strive for excellence, which recognises achievement and values people.

All the people asked said they enjoyed the meals and there was a choice of menu. People's weight was monitored and when necessary advice was sought from other healthcare professionals.

We found that procedures and training for all members of staff was in place for the prevention and control of infection.

We noted that all members of staff received the training they needed in order to provide safe and effective care for people using the service.

We saw that systems were in place to monitor the quality of the service provided. There was evidence to demonstrate that people were regularly consulted about the care and facilities provided at the home.