Archived: Appletree Care Home

This inspection took place on 16th January and was unannounced. At our last inspection in December 2013 the service had met all the regulations we looked at. Appletree Court Care Home provides accommodation, nursing and personal care for up to 77 older people, the majority of whom have dementia. The third floor supports people with residential care needs and the first floor and second floor supports people who also have nursing needs. On the day of our visit there were 70 people living in the home.

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 providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We found hat there were insufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people with complex needs in the home, staff told us they felt rushed and we observed a number of people waiting to be attended to during our visit.

You can see what action we told the provider to take at the back of the full version of this report.

People were mostly positive about the service and the staff who supported them. One person told us, “staff are very kind, patient and friendly.” We saw people being treated with warmth and kindness. Staff were aware of people’s individual needs and how they were to meet these needs. Relatives we spoke with were also positive about the service, staff and management. One relative told us,” “The nurses are amazing, excellent, the staff are so caring and gentle and there when you need them.”

The care staff we spoke with demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.

The registered manager had been in place since April 2007. She provided good leadership and people using the service, relatives and staff told us the manager promoted very high standards of care. One person told us “She does an amazing job in a very demanding workplace; she’s always here beyond her hours, she has the residents’ interests at heart.”

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Medicines were managed safely and that care workers and nursing staff had detailed guidance to follow when administering medicines. Staff completed extensive training to ensure that the care provided to people was safe and effective to meet their needs

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). There had only one application for Deprivation of Liberty Safeguards (DoLS) for people using the service at the time of our inspection, the manager had recently attended training, however there were a number of people at the service who may be unlawfully deprived of their liberty. We have asked the provider to take immediate action to refer them for an assessment to the local authority

The service had an open and transparent culture and encouraged people to provide feedback. Staff and the managers checked the service regularly and took action to make improvements.