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Archived: Adderley Care Home with Nursing

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Reports


Inspection carried out on 13 June 2013

During a routine inspection

Adderley Care Home with Nursing is currently in administration and is managed by Healthcare Management Solutions(HCMS), a management company appointed by the administrators. It is registered for 72 people but on the day of our visit there were 39 people living at the home.

We saw staff treated people with respect. Our expert by experience told us, �The staff were very attentive and hands on, laughing and joking with those who were awake.�

We observed care workers hoisting people this was done safely and care workers talked to the person during the process explaining what was happening.

We completed a SOFI in the dementia unit. This is a specific way of observing people to see what care they experience. We saw there were enough staff to meet people�s need. People were supported by staff to move freely about the dementia unit.

We saw the home was clean and tidy. There were systems in place to protect people from the risk of infection.

We saw there were appropriate systems in place for the recruitment of staff. Records showed all necessary checks were completed before people started work.

There was a system of auditing and monitoring the quality of the service provided. Incidents were analysed and action plans put in place to improve the service people received.

Inspection carried out on 13 March 2012

During an inspection looking at part of the service

Adderley Care Home with Nursing was in administration and was being managed by Healthcare Management Solutions(HCMS), a management company appointed by the administrators. We visited Adderley Care Home with Nursing on 13 March 2012 and 3 April 2012. The visits were to check compliance with a warning notice against regulation 9 (outcome 4) and compliance actions we issued following our visit on 20 January 2012. When we visited on 3 April 2012 there were 18 people requiring nursing care and 19 people requiring personal care.

On 13 March 2012 a relative told us they were happy with the care and accommodation provided. However we identified care did not always meet people�s needs.

When we visited on 3 April 2012 there had been a complete change in the management of Adderley Care Home with Nursing. The divisional director of HCMS was overseeing the home with a temporary manager and temporary peripatetic manager. The divisional director said that they were looking to have a period of stability with this management team.

We saw that care was meeting people�s needs and staff had received training in how to provide care safely. Care plans accurately reflected people�s needs.

People told us they were happy with the staff and the care. One person said, �I�m quite alright, no problems. The care worker�s ask if I�m ok, they bring me blankets if I�m cold.� Another person told us, �I like going into town, the girls are lovely.�

Inspection carried out on 20 January 2012

During an inspection in response to concerns

We carried out a responsive review of Adderley Care home with Nursing on 20 January 2012 because concerns were identified by visiting professionals about the standard of care people received. Issues were identified around the level of staff on the dementia unit �The Willows�, the care people received and the quality of their care plans. The last compliance review in August 2011 also identified concerns around assessment of peoples mental capacity and the proper recording of medication.

Adderley House Limited which includes Adderley Care Home with Nursing went into administration in August 2011, the administrators were KPMG. KPMG appointed Healthcare Management Solutions (HMS) to run the business until it could be sold. HMS had been managing Adderley Care Home with Nursing since September 2011. The home was being actively marketed. HMS told us they had a weekly conference call with KPMG to discuss the ongoing management of the home.

Adderley care home with nursing was registered to provide care for up to 72 people. On the day we visited there were 44 people in the home, 15 of which were in The Willows dementia unit. People in this unit have complex care needs including dementia, some people lack capacity and are vulnerable. We visited the Willows dementia unit and looked at four out of the 15 care plans of people accommodated in this unit.

Some people were not able to comment directly on the service so we spent time in the communal area in The Willows observing people�s care to help us make a judgment about their experience.

We saw that staff were not attentive to peoples needs and were not aware of people�s likes and dislikes with regards to their drinks. We also saw that staff did not help people to maintain their dignity. We observed one person being transferred from a chair to a wheelchair, the transfer took three attempts to complete and staff did not show competence to move people safely.

We looked at four peoples care plans and at the medication administration charts for the month of January 2012, we found that care needs were not accurately documented and medication charts not fully completed. We also saw that daily records were for people in The Willows were unsecure in a cupboard in the lounge area. One member of staff we spoke with told us they found care records confusing.

We looked at training records and found gaps in peoples training. The regional manager of HMS told us that they had concerns about the quality of the training previously delivered and that they intended to retrain all staff in all areas.

One relative we spoke with of a person who was not on The Willows unit told us they were happy with the care their sister received and that there were enough staff to provide care.

Inspection carried out on 2 August 2011

During an inspection looking at part of the service

People told us they were able to visit and have a look around before making a decision to stay and received information telling them about the home. One person said, �there�s no place like home but it is very nice�, another �You�ll go a long way to find a place as nice as this�. People told us staff respected their privacy and they could have visitors whenever they wished.

Some people were unable to tell us their views themselves because of their health and frailty, however, we saw that all had care plans and assessments in place for staff to refer to if needed and staff knew to do this. A staff member told us, �we get to find ways to communicate with people, we can offer choices to people by showing them things and we can usually read their facial expressions, or we ask their relative�.

Those people we spoke with made positive comments about the service such as, �I couldn�t wish for better. I am happy with everything�. Another person said �the staff are very kind, I have no complaints�. People unable to voice their opinions looked comfortable and well cared for.

People told us staff looked after their medication and they received it regularly.

People said they could speak to any of the staff if they were unhappy or had a problem and a visitor said they would speak with the manager and would feel comfortable to do so if they had concerns. Staff gave some specific examples of signs they looked out for to indicate whether people who were unable to communicate easily were unhappy.

People said there were enough staff on duty to meet their needs and they did not have to wait too long to be helped. They made positive comments about the staff such as, �the girls are very kind, they have made me feel very welcome here, I am very settled�.

Inspection carried out on 23 February 2011

During a routine inspection

Those people who could told us they were settled and satisfied with the care and accommodation they received. They said staff involved them in making decisions about their daily lives. One person said "I stay in bed late, which is my choice". For people less able to communicate their wishes, we saw care records were available for staff to refer to although some were less detailed and person centred than others.

People praised the staff and said what a good job they did. They said, "at night they are always checking me to see if I'm all right", although we did notice a person with dementia care needs was left without staff in attendance for 25 minutes. We also saw in one bedroom that ointment was not being stored securely.

Visitors told us there were usually staff around if they needed to speak to them and they were able to visit when they wished.

People told us they enjoyed the meals. One person said, ��I can�t fault the food��. They told us their personal preferences were catered for and they were offered alternatives if they did not like what was on the menu. We saw people who needed help with their meals were supported appropriately by staff.

People told us that they had access to outside professionals, such as doctors. One person said, ��my doctor comes in when I need him, the staff always get him for me��. For people unable to communicate easily with other people staff are available to support them support them.

People we spoke to told us they felt safe living in the home and was satisfied with the help and support provided. They said that they would feel comfortable speaking to any of the staff if they had any complaints or concerns. One person said, �They always sort things out for me�.

People told us they were satisfied with the cleanliness of the home and it was warm enough for them. We saw people's bedrooms contained personal items and effects to make them more homely.

We asked people if they felt they could influence how the home operated but they were unable to answer. They did, however, tell us staff asked them informally if they were satisfied with the service. One person said, "I am always asked if I am happy".

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