Archived: Apple Court Care Home

Updated 20 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was unannounced and took place on the 11 September 2015. A second day of the inspection took place on the 14 September 2015 which was announced in order to gather additional information.

The inspection was undertaken by two adult social care inspectors.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR) which was returned to us. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We also looked at all the information which the Care Quality Commission already held on the provider. This included previous inspections and any information the provider had to notify us about. We invited the local authority to provide us with any information they held about Apple Court Care Home and the Clinical Commissioning Group. We took any information provided to us into account.

During the inspection we talked with 10 people who used the service and six visitors. We spent time with people in the communal lounges and in their bedrooms with their consent.

Furthermore, we met with two regional managers from Leyton Healthcare (the provider) who were managing the home in the absence of the newly appointed manager. We also spoke with two nurses, four care staff and the handyman.

We undertook a Short Observational Framework for Inspection (SOFI) observation in one unit of Apple Court Care Home. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at a range of records including: five care plans; three staff files; staff training; minutes of meetings; rotas; complaint and safeguarding records; medication; maintenance and audit documents.

Updated 20 November 2015

This inspection was unannounced and took place on the 11 September 2015. A second day of the inspection took place on the 14 September 2015 which was announced in order to gather additional information.

Apple Court Care Home is a purpose built care home located in the centre of Warrington. It offers accommodation, personal and / or nursing care for up to 67 older people with memory problems associated with dementia. At the time of our inspection the service was providing accommodation to 51 people.

At the time of the inspection there was no registered manager at Apple Court Care Home. 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 2008 and associated Regulations about how the service is run.

The home was previously inspected in April 2015. We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safeguarding people from abuse and improper treatment; meeting nutritional and hydration needs; receiving and acting on complaints and staff training. We received a provider action plan which detailed that the provider would take immediate action to meet the relevant regulations.

We found that the provider had taken appropriate action to safeguard people from abuse and improper treatment. Likewise we found that the provider had taken appropriate action in response to complaints; meeting nutritional and hydration needs; receiving and acting on complaints; staff training and improved governance arrangements.

During this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

We found that registered person had failed to ensure that the people using the service were protected against the risks of unsafe or inappropriate recruitment practice as some key records had not been obtained.

Apple Court was being managed by two regional managers at the time of our inspection as the newly appointed manager was on annual leave. We have since been notified that this manager has resigned from post.

During the two days of our inspection, people living at Apple Court were observed to be comfortable and relaxed in their home environment and in the presence of staff.

People using the service and relatives spoken with were generally complimentary about the care provided at Apple Court.

For example, comments received included: “I feel safe and have no problems”; “I think it’s a lovely place”; “It is so clean. They clean everyday”; “They got the doctor out to my knee straight away”; “I am very well looked after. I couldn’t grumble about anything and the food is excellent”; “Staff are very good”; “You don’t go short of care”; “They respect you”; “Helping you isn’t too much trouble” and “We have new management. They are very open and honest about issues. They care and work hard.”

Some people raised concerns regarding the lack of activities, the use of agency staff and the standard of communication between staff. We have shared these concerns with the management team who assured us that they would take action to address the issues.

People using the service had access to a choice of wholesome and nutritious meals. Records showed that people also had access to a range of health care professionals (subject to individual need).

Systems had been developed by the provider to assess the needs and dependency of people using the service; to obtain feedback on the standard of care provided and to respond to safeguarding concerns and complaints.

We found that care planning records were in need of review to develop a more person-centred model. There was also conflicting information in some records which may have put people at risk. We also found that there remained some gaps on the training matrix and the quality assurance system was in need of review to demonstrate that the views of people using the service and their representatives were acted upon. We have made recommendations about these areas in the report.