• Care Home
  • Care home

Oldfield Bank Residential Care Home

Overall: Good read more about inspection ratings

5 Highgate Road, Altrincham, Cheshire, WA14 4QZ (0161) 928 0658

Provided and run by:
3A Care (Altrincham) Limited

All Inspections

30 May 2023

During an inspection looking at part of the service

About the service

Oldfield Bank Residential Care Home is a residential care home providing accommodation and personal care to older adults, including people living with dementia. Oldfield Bank accommodates up to 28 people in one adapted building. At the time of our inspection, there were 25 people living at the home.

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

People were happy with the care provided. The home had good leadership and regular staff who felt valued and were motivated to carry out person-centred care. People and their relatives were positive about the culture and ethos of the service. Staff reported a high level of job satisfaction.

Staff understood how to safeguard people and when to raise concerns. People received their medicines safely and recruitment practices were safe. Risks associated with people’s care were assessed and monitored. Staff followed infection prevention and control guidance to minimise risks related to the spread of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 18 November 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider reviewed how they recorded and managed concerns raised that were not managed as formal complaints. At this inspection we found the provider had acted on the recommendation and the necessary improvements had been made.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 1st and 2nd October 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oldfield Bank Residential Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

1 October 2019

During a routine inspection

About the service

Oldfield Bank Residential Care Home is a residential care home providing accommodation and personal care to older adults, including people living with dementia. Oldfield Bank accommodates up to 28 people in one adapted building. At the time of our inspection, there were 25 people living at the home. The home is located in a residential area of Altrincham, Greater Manchester.

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

People told us they felt safe and well looked after at the home. There were enough staff on duty to meet people’s needs, although at busy times, staff were not always able to complete tasks and provide people with prompt support. Although we did not find evidence of anyone having been harmed, medicines were not being managed safely, and people had not always received their medicines as prescribed. We also found staff were not following measures intended to help prevent people being harmed if they entered a kitchenette that contained a kettle.

We received positive feedback from health professionals with recent involvement in the service. They told us staff knew people well and made appropriate referrals. Feedback about the food provided was generally positive, although some people wanted more information about the choices available at meal times. The provider had undertaken a programme of re-decoration and redesign of the home since our last inspection. However, few adaptations to help make the environment more ‘dementia friendly’ were apparent.

We have made a recommendation about how the provider reviews good practice guidance in relation to developing dementia friendly environments.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received support from staff who knew them well and understood their needs and preferences. Staff treated people with respect and were patient in their interactions, including during busy periods of the day. Staff were receptive to people’s needs and responded effectively to provide support and reassurance when needed.

People’s care plans were detailed and person-centred. People told us they had been involved in planning their care. The home employed an activities co-ordinator and staff told us they felt the activities offer in the home had improved over the last year. People told us they would feel comfortable raising a complaint if needed and we saw the one formal complaint received in the past year had been responded to appropriately. However, it was not clear how the registered manager had responded to concerns that had not been raised through the formal process in one instance.

We have made a recommendation about how the provider records informal complaints.

Staff were positive about working at the home and told us they felt able to raise any concerns they might have with one of the management team. The provider continued to invest in the home, which included a continued refurbishment programme and the introduction of an electronic care management system. Staff were still learning how to use this system effectively, and there had been some recording issues related to its’ introduction. System and processes were in place to help the registered manager monitor the quality and safety of the service, although these had not been effective at identifying the issues we found, such as in relation to shortfalls in the safe management of medicines.

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

Rating at last inspection and update

The last rating for this service was requires improvement (report published 11 October 2018). This is the second consecutive time that the service has been rated requires improvement. At our last inspection, we found the service to be in breach of one regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection, enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safe management of medicines and having adequate processes in place to monitor the quality and safety of the service. Please see the action we have told the provider to take at the end of this report.

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. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will ask the provider and local authority to meet with us to discuss the improvements the service needs to make and the support they need to do this.

31 July 2018

During a routine inspection

This inspection took place on 31 July and 01 August 2018 and was unannounced. This is the first inspection we have carried out of this service under its’ current registration with the provider 3A Care (Altrincham). When we last inspected the service in October 2016, the service was being run by a different provider and was rated requires improvement overall. At this inspection we rated the home requires improvement overall, and identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to provision of safe care and treatment.

Oldfield Bank Residential Care Home (Oldfield Bank) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Oldfield Bank provides accommodation and personal care for up to 28 older adults, including people living with dementia, in one adapted building. Accommodation is across four floors, with a lift available between floors. The home is located in a residential area of Altrincham, Greater Manchester.

There was a registered manager who had been in post since May 2018, and was registered with the CQC in July 2018. 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.

Some staff had found the change in provider, and changes made to the management team by the new provider difficult to accept. This had resulted in some resistance to change amongst the staff team, although both staff and the registered manager felt this situation was improving.

The home provided accommodation to people staying on a permanent and temporary basis. We found people living at the home on a permanent basis had comprehensive care plans and risk assessments in place. However, we found this was not the case for one person staying on a temporary basis who did not have a complete care plan or risk assessments. We have recommended that the provider reviews how they manage and monitor temporary placements at the home.

There were sufficient numbers of staff to meet the needs of people living at the home. There were times when staff were particularly busy, and when communal areas were unsupervised for short periods of time. However, we did not observe any issues when these instances arose or any significant delays in people receiving the support they needed.

Staff took steps to help ensure risks to people’s health, safety and wellbeing were reduced. This included using sensor mats, providing support and supervision and ensuring people had mobility aids to hand. However, in one instance, a person had a bed sensor mat in place and informed us they had not consented to this. This demonstrated staff did not always balance risk management with people’s rights to make informed decisions effectively. This issue was addressed when we raised it with a manager.

We identified some shortfalls in the safe management of medicines. Medicines were not always stored securely or recorded accurately. For example, we found the door to the treatment room open on one occasion and the keys for the medicines trolley and controlled drugs cupboard were inside the treatment room. Night staff did not administer medicines, and had to contact the on-call staff to administer any ‘when required’ medicines such as pain relief. This could result in potential delays in people receiving their medicines.

The provider was in the process of fitting magnetic locks to stairwell doors at the time of the inspection to help reduce the risk of people injuring themselves who were not able to use the stairs safely without assistance. Required checks and servicing of the premises and equipment had been carried out in most cases. However, we found there was no legionella risk assessment and the passenger lift thorough examination was overdue. Actions were taken during the inspection to address these shortfalls.

We observed that the majority of staff interacted well with people living at the home. Staff acted respectfully and were attentive to people’s needs and comfort. There were some long-standing staff members at the home and only limited use of agency staff. We observed one isolated incident where a staff member started to position a person’s leg to support them to transfer from their chair whilst they were asleep. However, the remainder of interactions we observed were positive and staff communicated well.

Staff encouraged people to retain their independence, and care plans reflected people’s abilities as well as their support needs. Staff told us they would be happy for a friend or family member to live at the home because of the caring nature and commitment of the staff working there.

People told us staff respected their privacy and dignity. However, we also received a comment that there was limited space for people to meet visitors in a quiet or private area other than their bedrooms. The provider was in the process of refurbishing the home and this included plans to create a family/waiting room.

Care plans were person-centred and comprehensive. People told us they had been involved in planning and reviewing their care, and they told us staff acted to meet their preferences.

Staff received regular supervision and a range of relevant training. The registered manager was in the process of reviewing training provision and recognised that improvements could be made in this area. For example, only basic training was provided in relation to dementia care.

Staff worked with other professionals to meet people’s healthcare needs. We received feedback from one healthcare professional who told us staff acted upon the advice they gave in relation to people’s care. The service considered whether people staying at the home short-term may need to be supported to register with a local GP practice on a temporary basis.

We received positive feedback about the food provided. We saw the cook considered people’s dietary requirements and preferences when preparing food.

People told us they would be confident to raise any concerns they might have. We saw that staff had effectively identified and recorded complaints whether written or raised verbally. Complaints had been investigated and responded to appropriately, with actions taken to improve the service when necessary.

The registered manager had introduced a range of audits and checks to help them monitor the quality and safety of the service. However, the checks had not identified the issues we found relating to the safety of the service, nor ensured they had been addressed.

The opinion of people using the service and their representatives had been sought, and feedback provided on how staff had acted upon their views. The service acted upon feedback from relevant others such as the local authority and infection control lead.

Staff told us the new provider was investing in the service, and we saw a refurbishment was underway. The new provider and registered manager had started making a number of improvements. This included installing a new call-bell system, enclosing the garden area, improving care plans and introducing a new electronic care planning and records system, which was due to go live shortly after the inspection.

Staff told us the registered manager was approachable and they felt motivated to provide good quality care. The registered manager had clear plans for how they wanted to work with staff to continue to improve the quality of the service.