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Altham Court Care Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 9 October 2019

During a routine inspection

About the service

Altham Court Care Home is a care home providing personal and nursing care to 48 people for people aged 65 and over. Altham Court Care Home is located in Lincoln.

People’s experience of using this service and what we found

Although people and relatives felt the service was safe, we found concerns with the reporting of low level safeguarding issues. However, accidents and incidents were monitored and recorded appropriately. Where staff were administering medicines, they were administered and stored safely. However, where people administered their own medicines, these were not always stored safely. Risks to people’s safety had been assessed and we saw examples of people being supported to take positive risks. The processes in place ensured people were protected from infection. Agency staff were used to cover shortfalls on the rota, however, occasionally safe staffing levels were not met. People were supported by staff, the provider carried out pre-employment checks for staff. Where there were volunteers providing an activity for people, in the service appropriate checks had not been carried out.

We recommend that where volunteers are used to provide activities in the service, appropriate checks are carried out by the provider.

Peoples capacity had been assessed where it was thought people lacked capacity to make a specific decision. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; the policies and systems in the service promoted this. People’s nutrition needs were supported. People’s needs were assessed, and people were involved in their care planning. The premises were fit for purpose and had an accessible garden. Staff received on going training to support them in their role. People had access to health care services, however this was not always managed in a timely way.

Staff did not always speak about people with dignity and people’s choices were not always respected. However, some staff interacted positively with people. People told us staff worked to maintain their privacy.

People’s care and support had been planned in a person centred way, however there was a lack of personalised activities in the service. Records showed formal complaints had been recorded and action taken, however, re-occurring concerns and actions taken had not been recorded. People communicated using a variety of different methods and they were supported to follow their chosen faith. People received meaningful end of life care from staff who were passionate about providing this care to the people they supported.

The registered manager had quality monitoring systems in place to monitor the standards of care. However, actions identified had not always been signed off as complete. People who used the service had limited access in to the community. There was not always a positive culture from people in relation to leadership in the service. The organisational values had not been fully embedded in to the service. There was a lack of clarity, at times, for staff roles however, staff felt supported by the registered manager. The service had positive relationships in the community. Staff felt empowered by to develop with the organisation.

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

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Inspection carried out on 29 March 2017

During a routine inspection

This inspection took place on 29 March 2017 and was unannounced. Altham Court provides care for older people who have mental and physical health needs. It provides accommodation for up to 48 people who require personal and nursing care. At the time of our inspection there were 33 people living at 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 2008 and associated regulations. There was also an Acting Manager in post who was in the process of applying to CQC to register as the new registered manager for the home.

On the day of our inspection staff interacted well with people. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe from abuse including financial abuse.

Protocols were in place for as required (PRN) medicines. Medicine administration sheets were not completed according to the provider’s medicines policy. Arrangements were in place to keep medicines stored safely.

We saw that staff obtained people’s consent before providing care to them. The provider did not consistently act in accordance with the Mental Capacity Act 2005 (MCA). Best interests assessments were not clearly documented. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the Deprivation of liberty Safeguards (DoLS) and to report on what we find. We found that the provider acted in accordance with DoLS.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

We found there were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support.

Staff had the knowledge and skills they needed to care for people in the right way and they had received most of the training and guidance they needed. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received supervision. People were encouraged to enjoy a range of social activities. They were supported to maintain relationships that were important to them.

Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Regular audits were carried out and action plans put in place to address any issues which were identified. Accidents and incidents were recorded and investigated. The provider had sent us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.