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Althorpe Residential Home Good

Reports


Inspection carried out on 3 April 2019

During a routine inspection

About the service: Althorpe Residential Home care home is situated in the centre of Althorpe village. The service provides accommodation and personal care for up to 20 people some of whom are living with dementia.

People’s experience of using this service:

Issues found under the safe domain at the last inspection, relating to medicine management, infection prevention and control and the general décor of the service had been addressed.

People were protected from the risk of harm and abuse. Safeguarding procedures guided staff about the action they must take if they suspected abuse was occurring. People had risk assessments in place to identify hazards to their health or wellbeing. Action was taken to reduce risks but maintain people’s independence and choice. There were enough staff to meet people’s needs in a timely way. Incidents and accidents were monitored and corrective action was taken to prevent re-occurrence. Recruitment and medicines management was robust. Infection prevention and control was in place.

Staff undertook training had supervision and a yearly appraisal to help to maintain and develop their skills. This helped staff meet people’s needs.

People had their capacity assessed and were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were caring and kind. People we spoke with and their relatives confirmed this. Staff provided comfort and support if people became anxious or upset. Information was provided to people in a format that met their needs in line with the Accessible Information Standards.

Staff supported people to meet their health and nutritional needs. People were supported and encouraged to maintain their independence. Staff worked with health care professionals to maintain people’s wellbeing.

People felt able to raise concerns and were confident they would be addressed. There was a good programme of activities in place. End of life care was provided at the service.

The service was well-led. The registered manager supported the staff team and they all worked well together. A range of quality checks and audits were undertaken to monitor the service provided. Action plans were created when shortfalls were found and corrective action was undertaken to improve the service provided. We found the electrical hard wiring five-year certificate had been lost and a duplication could not be gained. This electrical check was undertaken again just after the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (Report published October 2016).

Why we inspected: This was a planned inspection based on the previous inspection rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 1 August 2016

During a routine inspection

This inspection was carried out on 1, 3 and 17 August 2016, and was unannounced. It was undertaken by one adult social care inspector. The service was last inspected on 6 January 2015 when it was as rated Requires Improvement in the Safe and well-led domains. This was because people had not always received their medication as prescribed by their GP. Some medicines had been recorded by the staff as being given when they had not been; one person had not received their medicines for a few days because none were available. Management auditing had not picked these shortfalls up. During this inspection we found the issues from the last inspection had been addressed.

Althorpe Nursing Home is registered with the Care Quality Commission (CQC) to provide accommodation for up to 20 people who may be living with dementia. Accommodation is provided over two floors. The service has a garden and there is a car park for visitors to use. Although the service is registered to provide nursing care to people it currently only provides a service to people who require personal care. The signage provided at this service reflects this.

There was a new registered manager in post who had just commenced in this role. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood they had a duty to protect people from abuse and knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission (CQC). This helped to protect people.

We observed the staffing levels provided during our visits were adequate to meet people’s needs. Staff undertook training in a variety of subjects to develop and maintain their skills, training was updated periodically, as required.

Staff supervision was in place and a programme of appraisals had just commenced which helped to support the staff.

People’s nutritional needs were assessed; their preferences and dietary needs were known by staff and they were catered for. Staff encouraged and assisted people to eat and drink, where necessary.

Staff supported people to make decisions for themselves. They reworded questions or information to help people living with dementia understood what was being said. People chose how to spend their time and consented to their care.

People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.

During our inspection we found some shortfalls in the environment, with infection control and the review of one person’s health when their needs changed. Action was immediately taken by the registered manager to address the issues found.

The registered manager undertook a variety of audits to monitor the quality of the service. Issues we found at the time of our inspection were acted upon straight away.

There was signage in place to help people find their way to the toilets and bathrooms. Staff helped to guide people to where they wished to go. The communal areas were located on the ground floor. General maintenance occurred and service contracts were in place to maintain equipment so it remained safe to use.

A complaints procedure was in place. This was explained to people living with dementia or to their relations so they were informed. People’s views were asked for informally by staff and by the registered manager and registered provider. Surveys were about to be sent out to gain written feedback from people about the quality of the service provided. Informal feedback received was acted upon to help people remain satisfied with the service

Inspection carried out on 5 & 6 January

During a routine inspection

Althorpe Nursing Home is registered with the Care Quality Commission (CQC) to provide care and nursing care to a maximum of 20 people, some of whom may be living with dementia. It is situated in the centre of Althorpe village; local amenities are within walking distance, for example, local pub, church and village shop. The service also offers day care and respite services.

People’s bedrooms are located on the ground and first floors. The first floor is accessed by a passenger lift. There are enough toilets and bathrooms for people to use and these are fitted with aids for the staff to use to help people who have limited mobility. Some of the rooms have en-suite toilet and bathroom facilities.

Communal areas consist of a large lounge and a dining room and the gardens are accessible.

This inspection took place on the 5 and 6 January 2015 and was unannounced. The service was last inspected in January 2014 and was found to be compliant with the regulations inspected at that time.

At the time of the inspection 12 people were living at the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People did not always receive their medication as prescribed by their GP. Some medicines had been recorded by the staff as being given when they had not been; one person had not received their medicines for a few days because none were available. This was brought to the attention of the manager on the day of the inspection.

People who used the service were cared for by staff who understood they had a duty to protect people from harm and keep them safe. Staff gave examples of what they may see if someone was being abused and understood how to report this to make sure the person was protected.

People were cared for by staff who had been recruited safely and provided in enough numbers to meet their needs. Staff were provided with information about how to keep people safe and make sure they were not a risk to themselves and others.

People lived in a well maintained, clean environment and people could bring their own furniture with them when they moved in.

People were cared for by staff who had received training and support and who understood their needs. Where people had been identified as needing support with making informed decisions systems were in place which protected the person and made sure decisions made on their behalf were in their best interest.

People were provided with a wholesome and nutritious diet of their choosing. Choices were provided at meal times and staff monitored people’s dietary intake and involved health care professionals when needed. The service catered for people’s cultural or chosen diet, for example, providing a vegetarian diet for one person who used the service.

People were supported by staff to keep healthy and to attend health related appointments where needed. They also called people’s GPs if they felt unwell and worked closely with the district nursing team.

People were involved with their care and their choices and preferences were recorded; staff understood the importance of respecting these and ensuring people’s rights were upheld. People’s dignity was respected by the staff. People were cared for by staff who knew them and understood their needs and with whom they had good relationships.

People could access the service’s complaint procedure if they felt the need to complain. Complaints were investigated and resolved to the complainant’s satisfaction and information was provided about who to contact if the complainant was unhappy with the way their complaint had been investigated.

People were provided with a range of activities to choose from; an activities co-ordinator was employed who made sure people were supported to participate in activities. People who chose to stay in their rooms were engaged as much as possible to make sure they did not become isolated.

People were involved with the running of the service and were consulted about their opinions as to how the service was run. Others who had an interest in the care and welfare of the people who used the service were also consulted, this included relatives and health care professionals. The registered manager undertook regular audits which made sure the service was run safely and people were not exposed to unnecessary risks, however, these audits had not picked up some medicines errors.

Inspection carried out on 17 January 2014

During an inspection looking at part of the service

We found that, since our last inspection in August 2013, there had been improvements in the way people's care was planned and delivered. We also found that systems had been put in place to ensure that people's health and accidents and incidents were monitored.

We saw the manager had completed quality monitoring tools and put action plans in place where these had identified areas for improvement. The manager had asked people for their views on the care provided and received very positive feedback.

Inspection carried out on 20 August 2013

During a routine inspection

Just prior to this scheduled inspection we received concerns about some aspects of the care that people received at the service. We reviewed the areas of concern as part of this inspection. We also referred the concerns to the local safeguarding team and they are making their own enquiries.

We spoke to some of the people who used the service. We found that the majority of people were unable to give us detailed information about the service due to their mental health needs. We also spent time observing the care and staff interactions with people in the communal areas of the home.

We found that care and treatment was not always planned and delivered in a way that would ensure people's safety and welfare. This was because care plans had not always been developed where care needs had been identified and they had not always been updated when care needs had changed.

We found people were supported to be able to eat and drink sufficient amounts to meet their needs. We also found that people were provided with a choice of suitable and nutritious food and drink. People told us they enjoyed the food and said they had a choice.

We found that there had been major refurbishment of the premises, this had caused some issues with the hot water supplying some parts of the building but these issues were now resolved.

We observed good interactions between staff and people who used the service and people told us they were happy at the home.

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Inspection carried out on 29 May 2012

During a routine inspection

People we spoke with were very positive about the care and support they received. They told us they liked living at the home Comments included �I am always very happy when I come here,� �It couldn�t be better� and �It�s excellent.�

They told us they felt safe living in the home. Comments included �Yes, I feel safe� and �I feel safe coming here.�

They also told us that they liked the staff that cared for them. Comments included �The staff are lovely and very willing� and �The staff are all nice.�

Inspection carried out on 17 February 2012

During a routine inspection

People we spoke with were very positive about the care and support they received. They told us they liked living at the home and confirmed they were supported to make choices and decisions about the care they received. They told us they were assisted to be as independent as possible. Comments included �It�s not too bad,� �I am well looked after,� �They let me be independent,� �It�s very nice here� and �They ask you what you want to do.�

They told us they felt safe living in the home. Comments included �Yes, I feel safe, I have no complaints� and �I feel safe coming here.�

They also told us that they liked the staff who cared for them. Comments included �They are all right really,� �They are lovely people� and �The staff are lovely, very kind.�

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