Archived: Alsager Court Care Home with Nursing

Updated 14 December 2016

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 is 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.

We undertook a focused inspection of Alsager Court on 24 October 2016. We carried out this inspection in response to concerns raised by a member of the public about the standard of care provided at the home. We inspected the service against one of the five questions we ask about services: is the service safe? This was because the concerns raised by the member of the public highlighted a risk that the provider may not meeting legal requirements in relation to this question.

The inspection team consisted of two adult social care inspectors.

Before our inspection we reviewed the information we held about the service. We reviewed notifications of incidents that the provider had sent us since the last inspection. A notification is information about important events, which the service is required to send us by law. We also reviewed information from the local authority commissioning team.

During the inspection we spoke with four people who lived at the home, two visitors and one visiting GP. We also spoke with staff including the registered manager, an agency nurse, one care assistant and two agency care assistants.

During the inspection we made observations of the care and support provided to people, including how the staff interacted with the people. We also made specific observations of the way that people were supported when they remained in their bedrooms. We completed a tour of the home and inspected bathrooms, toilets, the lounge and dining room. We examined a number of records relating to the day to day management of the service including staff rotas, complaints, handover records and audits. We also inspected three of the care records of people living at the home.

After our inspection we contacted a GP practice and the local authority quality assurance and contracts team for their views about the service.

Updated 14 December 2016

This focused inspection took place on 24 October 2016 and was unannounced.

We previously carried out an unannounced inspection of this service on 7 December 2015 and 11 January 2016. After that inspection we received concerns in relation to the standard of care, specifically about the use of agency staff and their knowledge of people’s needs, the appropriate management of risk and safeguarding the people who lived at the service. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those concerns. You can read the report from our last inspection, by selecting the 'all reports' link for Alsager Court on our website at www.cqc.org.uk.

Alsager Court Care Home with nursing is part of the Blanchworth Care group and is registered with the Care Quality Commission (CQC) to provide accommodation and personal care with nursing for up to 27 older people. During the inspection there were 21 people living at the service, including one person who was in hospital.

There was a registered manager in post at the time of our inspection. 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.

Overall we found that people were comfortable and at ease in the home's environment. The people and relatives’ who were able to speak with us provided positive feedback. We found that the registered manager understood her responsibility to identify and report any suspicion of abuse. Where necessary she had taken appropriate action to protect people so that their safety was maintained.

We found that there were sufficient staff to meet the needs of people living at the home. The registered manager was knowledgeable about the people living at the home and used this knowledge to determine staffing levels, although there was no specific tool that was used for this purpose. Therefore we recommend that a suitable staffing tool is sourced and utilised, to ensure a systematic approach to determine the number of staff and range of skills required to meet people’s needs.

The level of agency staff being used by the home had recently increased. The registered manager demonstrated that she was actively recruiting new staff and there were people in the recruitment pipeline awaiting appropriate recruitment checks. Agency staff were given information about people’s needs but we found that this information needed to be more robust and consistent. The registered manager was already in the process of re-instating care folders which would contain a one page profile of people’s needs.

People’s care records contained a number of risk assessments according to their individual circumstances including risks of pressure ulcer, falls, weight loss and bedrails. Risk assessments identified actions were put into place to reduce the risks to the person and were reviewed regularly. We specifically looked at the risks to people around maintaining a safe environment to ensure that staff used the safest procedures when supporting people. Staff were required to carry out frequent monitoring checks for some people. Staff were required to sign charts which indicated when they had carried out these checks. We found that the monitoring records were not entirely accurate all of the time, although people were monitored on a regular basis. We recommend that staff should accurately record the time of any observational checks, so that these correctly reflect the times that the observations were carried out.

Care plans provided detailed and updated information about people’s care needs. However in one case we found that some aspects of the care being provided had not been detailed fully in the care plan.

We could not improve the rating for safe from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection