Archived: Albemarle Court (Nottingham) Ltd T/As Albemarle Court Nursing Home

Below is a summary of what we found. the summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

One person told us they had been visited by two of the care home staff prior to agreeing to their admission. They told us these staff had provided them with verbal information about the aims, objectives and purpose of the service and the facilities that were available. This meant people who used the service could be confident they would be looked after in a safe environment.

We saw a robust recruitment procedure was in place and relevant checks had taken place to ensure appropriate skilled staff were employed.

Staff were supported to gain further qualifications in social care and attend training relevant to their role. Staff told us there was enough training on offer to support them to do their job.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, staff were able to describe the circumstances when an application should be made and knew how to submit one.

Is the service effective?

We found that the provider promoted and respected people's privacy, dignity, independence and human rights by placing the needs, wishes, preferences and decisions of people who used the service at the centre of assessment, planning and delivery of care, treatment and support.

When people were at risk, staff had followed effective risk management procedures to protect them. The five care plans we looked at showed that risks such as pressure ulcers, falls, mobility, and nutrition were all considered from the point of admission and reviewed at regular intervals. A relative told us, 'The pressure ulcers my relative was admitted with have now healed.' A person who used the service told us, 'Since coming here they have helped me walk independently. I have received intensive physiotherapy and the staff have encouraged and supported me each day. I am looking forward to going home soon.'

Is the service caring?

We looked at the way care and treatment was planned for three people who used the service. Records we looked at recorded how external professionals were involved in discussions about changes in people's health and wellbeing. We saw how choices and treatment options were discussed and recorded. We saw how those people that did not have the capacity to be involved had been supported by their next of kin when important decisions about care and treatment were discussed.

We saw staff were attentive to people's needs and supported them when required. We observed staff hoisting people from their wheelchairs to an easy chair to make them more comfortable. We heard staff talking to people in a polite and respectful manner.

We saw staff supporting people to eat and drink. One person told us the staff cared for their needs and said, 'We all get on very well.'

Is the service responsive?

We found there were opportunities for relatives to meet and one relative told us they had received a copy of the minutes from last meeting. A visiting relative told us, 'The last meeting we had was much better, they took minutes and we all received a copy. They have listened to us and made improvements such as helping more residents to sit at the dining tables for meals instead of leaving them in armchairs.'

In three records we looked at there was information on each person's religious belief. Staff told us that a religious service was held at the home by a visiting clergy; however they were unsure what church this person represented.

Is the service well led?

We saw arrangements were in place to deal with foreseeable emergencies. The person in charge showed us the system they had implemented to ensure each person had relevant information to identify their needs should an emergency occur. We saw each person had an evacuation plan outside their room which identified the level of risk if there was a need to evacuate the home.

There were systems in place to monitor care and treatment, but the systems did not ensure staff had followed the correct guidelines and recommendations.

People we spoke with told us they had noticed improvement to the way the service was run. One person told us they felt they were listened to.

We saw different audits were undertaken to measure the quality of the service and identify where improvements should be made.

People who used the service were not able to move independently between all the floors of the home and they had to wait for staff in order to go to lower floors; their movement was restricted.

One staff member told us, 'People's wishes aren't always respected and care isn't given according to their wishes.'

A relative told us, 'I'm quite pleased with the care my relative gets.'

During our inspection we observed that staff assisted people who used the service. We noted that staff were not always present in the communal lounge.

A staff member said, 'As a whole, the care is ok but there's room for improvement.'

During our tour of the premises we observed that the environment in communal and individual bedrooms looked clean.

Staff we spoke with were not confident they had received an appropriate induction before they started work.

We found that all of the staff files we looked at had information missing which was required as part of their recruitment procedure.

On the day of our inspection, we saw there were gaps in training for the majority of staff.

We noted that some audits had been completed. However, other audits had not been completed in a regular or consistent manner.

The financial records were signed for by only the administrator in most of the records we looked at. This meant appropriate systems were not in place to protect people's finances.

We saw staff did not always respect people's privacy and dignity at all times.

We found people who use the service were given information and support regarding their care to enable them to make an informed choice.

We looked at a number of care files. The plans of care were personalised and reflected people's choices and preferences. Relevant risk assessments were in place and family members had been involved with the care planning.

We spoke with relatives and they were complimentary towards the staff. One relative said, 'My family member has been unwell, we noticed a change in their mood. When we spoke to the nurse in charge they had also noticed the change and put actions in place for medical attention.'

Staff had a good understanding regarding safeguarding concerns and who they should report to.

The home looked clean and tidy, but we found concerns regarding some of the cleaning practices. There were no cleaning schedules in place for equipment such as bedrail bumpers, beds, chairs, cushions and wheelchairs.

Staff told us they felt supported by the management team at all times.