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Cuerden Developments Limited - Alexandra Court Requires improvement

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Inspection report

Date of Inspection: 21 July 2014
Date of Publication: 19 August 2014
Inspection Report published 19 August 2014 PDF | 94.39 KB


Inspection carried out on 21 July 2014

During an inspection in response to concerns

During this inspection the Inspector gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

During the inspection we looked at care and welfare, cooperating with other providers, supporting workers, quality assurance and complaints.

This is a summary of what we found, using evidence obtained via observations, speaking with staff, speaking with people who used the service and their families and looking at records:

Is the service caring?

During the visit we saw staff offering care with patience and courtesy. Staff made efforts to ensure people’s dignity and privacy were preserved at all times.

The service provided people with information about the service and a questionnaire on admission to ensure their expectations were understood and needs met as far as possible.

We spoke with four people who used the service and six visitors. One person who used the service said, “Staff have been great – can’t do enough for you”. Another told us, “Staff are pleasant and polite. I have been here before but it is better this time”. A third person said, “I like it here, I’ve only been in a short while, but staff are all nice and helpful”.

A visitor remarked, “We have no complaints whatsoever. We are made welcome and staff have made drinks for us”. Another visitor commented, “You are made very welcome, you can make a drink, which we appreciate as we come a long way”.

Is the service responsive?

Assessments were carried out prior to people being admitted, to ensure they were in the correct place to meet their needs. We were told that personal goals were agreed between people who used the service and therapy staff and all staff would then work towards these with the person.

Care plans were contributed to by the person and their family, the care staff and therapy staff. This helped ensure all were aware of the progress being made and plans being followed.

People's support needs and abilities were reassessed on a daily basis and risk assessments were reviewed on an on-going basis to ensure individuals' progress was on track.

Complaints and concerns were generally responded to appropriately. However, we found an example of a complaint that had not been addressed in a timely or appropriate manner and the omission had not been picked up in the audit process. We asked the manager to deal with this as soon as possible.

The service worked closely with other agencies, such as the Stroke Association, Think Ahead, Carer Support and Age UK to ensure people obtained all the assistance and support they needed to help them make a good recovery. Appropriate referrals were made to other services, such as falls service, when required.

Is the service safe?

We saw evidence that care staff were recruited safely and the induction procedure was thorough. Staff told us they were well supported by management.

There were sufficient numbers of staff on duty at the service to ensure people’s needs were met safely. The service was looking at dependency levels of people who used the service, so that people with higher dependency levels could be accommodated on one floor. This would help inform staffing levels and expertise for each level.

Staff training was up to date and on-going and staff with whom we spoke had a good knowledge of care planning, care delivery and risk assessing. Staff with whom we spoke understood how to recognise deteriorating health and well-being and were aware of how to address this.

Areas of high risk, such as falls, were constantly monitored and methods implemented to try to minimise the risk.

Health and safety checks were carried out regularly and the building and equipment were well maintained.

Accidents and incidents were appropriately recorded and audited. Any patterns were analysed and problems addressed in a timely way.

Is the service effective?

The service had a mixture of care and therapy staff in order to try to meet both the social and health needs of people who used the service. There was also a GP who attended the service five days per week to contribute to the multi-disciplinary provision within the home. Staff with whom we spoke demonstrated a good understanding of their roles and responsibilities and all felt they worked well with other disciplines as a team. One staff member told us, “Everyone plays their part, there is good communication, good rapport and team work”

Care plans we looked at included factual and up to date information about people’s health and support needs.

Recent questionnaires filled in by people who used the service indicated a high level of satisfaction. Comments included, “Lovely place, nice people”, “Meals were not terrible, but not wonderful, and, “Staff were brilliant, kind, understanding and patient”.

Is the service well-led?

The home had a manager in place at the home, who was appropriately registered with the Care Quality Commission.

A significant number of audits were undertaken, some internal and some external. The results of these were analysed and any shortfalls addressed to help ensure consistent standards of care within the service.

Questionnaires were completed with people who used the service, to gain their opinions and suggestions and gauge their level of satisfaction. Results were analysed and used to inform continual improvement to the service.