Albert House Residential Home

We found the following examples of good practice.

There were plentiful supplies of personal protective equipment (PPE). Staff had been trained in infection control practices and posters were displayed to reinforce procedures. We observed staff were using PPE appropriately and disposal arrangements were safe. There were sufficient staff to provide continuity of support should there be a staff shortage.

Admission to the home was completed in line with COVID-19 guidance. People’s health and well being was carefully monitored during this time.

People were supported to stay in contact with their relatives and friends. Arrangements were in place for any person living in the home who wished to have a designated visitor.

The layout of the service and the communal areas were suitable to support social distancing. The premises had a good level of cleanliness and was hygienic throughout. Care staff were following an enhanced cleaning schedule and there was good ventilation. The atmosphere of the home was calm and peaceful. We observed staff were attending to people’s needs and people were enjoying various activities.

The provider’s infection prevention and control policies and procedures were up to date and audits had been carried out on a regular basis. The provider also had a business contingency plan and had developed guidance and risk assessments in relation to the current pandemic.

Albert House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered to accommodate 29 people across two separate units, each of which has separate adapted facilities. One of the units specialises in providing care to people living with dementia. At the time of the visit there were 28 people who lived at the home.

At the last inspection in October 2016 the service was rated 'Good'. At this inspection we found the service remained 'Good'.

A registered manager was available at the home. 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.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the service. Our observations and discussions with staff and relatives of people who stayed at the service confirmed sufficient staff were on duty. Before the inspection we had received concerns about insufficient staffing levels at the home. We found the provider was in the process of recruiting an additional member of care staff in response to the concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. The service had taken appropriate action where people lacked the capacity to make decisions about their care and needed to be deprived of their liberty to keep them safe.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care.

Risk assessments had been developed to minimise the potential risk of harm to people who stayed at the service. These had been kept under review and were relevant to the care and support people required. Additional measures had been taken to minimise risks in response to serious incidents that had occurred in the home.

We found improvements were required to demonstrate how staff observed people after falls and documentation and to ensure people at risk of choking were adequately monitored. There was no business contingency plan which would provide staff with guidance on dealing with unplanned events and emergencies in the home.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who stayed at the service were all positive about the quality of meals provided. One person said, “The food here is the best.”

We found people had access to healthcare professionals and their healthcare needs were met.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of Albert House. These included external audits, regular internal audits of the service, surveys and staff and relatives meetings to seek the views of people about the quality of care being provided.

Albert House residential Home provides care and accommodation for up to 29 older people, including seven places for people with the specific needs relating to living with dementia. Accommodation at the home is based over two floors. Thirteen of the bedrooms are ensuite and there are accessible toilet and bathroom facilities on both floors. The service is situated on the main road in Colne town centre and is close to the town's facilities and amenities.

At the time of our inspection the service had a registered manager who had been in post since 2011. 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.

The service was last inspected on 17 January 2014 and was found compliant in all areas inspected.

During our inspection we found that there were appropriate policies and procedures in place for the safe management of medicines. We observed staff administering medicines and saw that people received their medicines as and when they should.

People living at the home told us the home environment was safe and they received safe care. Everyone we spoke with was happy with staffing levels at the home and felt that staff had the knowledge, skills and experience necessary to meet their needs.

We saw evidence that staff had been recruited safely. The staff we spoke with understood how to safeguard vulnerable adults from abuse and what action to take if they suspected abusive practice was taking place.

We found that staff received an appropriate induction, effective training and regular supervision. Staff told us they felt well supported by management at the home.

Staff understood the main principles of the Mental Capacity Act 2005 (MCA) and sought people’s consent before providing care and support. The service had taken appropriate action where people lacked the capacity to make decisions about their care and needed to be deprived of their liberty to keep them safe.

The people we spoke with told us they were involved in decisions about their care and their care needs were reviewed regularly. We found evidence that where people lacked the capacity to make decisions about their care, their relatives had been consulted.

People living at the home were happy with quality of the food provided. They told us they had lots of choice at mealtimes.

People’s healthcare needs were met and we received positive feedback from community healthcare professionals about standards of care at the home.

We observed staff communicating with people in a kind and affectionate way. People told us staff respected their privacy and dignity and encouraged them to be independent.

People were supported to take part in a variety of activities inside and outside the home. People told us they were happy with the activities available.

We saw evidence that the registered manager requested feedback about the service from people living at the home, their relatives and staff and acted on the feedback received.

People told us they thought the home was well managed. They felt that the registered manager and the deputy manager were approachable.

The registered manager regularly audited many aspects of the service. We found that the audits completed were effective in ensuring that appropriate standards of care and safety were maintained at the home.

At this inspection in January 2014 we looked at the relevant records and discussed them, and the progress made, with the manager. We found the records in question had been sufficiently improved to ensure compliance with the regulation. For all residents the written assessments of their needs and their care plans had been reviewed and updated and included more information about how staff needed to look after them. This included written assessments of the risks associated with some aspects of care, including the risks of developing pressure sores and the risks associated with poor nutrition. This should help staff look after people safely.

We also found that staff records had been improved. Information about people's previous qualifications had been collected and recorded. There were also records of the induction completed by new members of staff. These records helped to demonstrate staff were suitable for employment.

All the residents said they were treated with respect and their right to privacy and dignity was upheld. One resident said, "Carers always speak politely to me and knock on my door in the morning". Another said, "The staff are all polite here; they do respect you".

Some people recalled speaking to staff about the care and support they needed. One person said, "I know as much as I need to know". However most people did not know they had a 'care plan' and there was no evidence that people had agreed to the information written down about their care needs.

Everyone we spoke with, including relatives, were complimentary about the home and the staff. They made the following comments: "I'm a happy lady; I get very good care", "I think the staff are very good with me; they know what I like to do", "This is a good home. It was recommended by a friend and I can see why". However we saw the written information about people's care needs should be improved, including recording more information about dementia related needs.

There was sufficient equipment to help people with mobility problems, including in the bathrooms and toilets. The equipment was appropriately maintained.

We saw staff recruitment processes needed to be improved to help ensure residents were protected from unsuitable staff.

At our recent inspection in March 2013 we spoke with some people living in the home (residents), four members of staff including the deputy manager, and spent time observing some aspects of support given to people in the dementia unit. Staff informed us there had been an improvement in the care and support practices for people with dementia. They had undertaken training since the last inspection and had a better understanding of the needs of people with dementia and how to support them. Staff spoken with also told us there had been changes to the staff team working in the dementia unit that had resulted in more people working there with the right skills and interests.

We observed residents being supported with patience and kindness. The staff on duty at the time of our visit spoke respectfully to residents and explained to them what they were doing, such as being assisted to the dining room. We also saw staff assisting people with their meal in an appropriate manner. They did not rush and interacted with the residents in a pleasant and respectful way. Residents we spoke with told us staff treated them properly and were kind.

People also felt they had sufficient choices in their daily routines. They told us they could get up and go to bed when they wanted, spend as much time in their room as they preferred and had a good choice of meals. They told us there were some activities such as games, exercises and the occasional trip out. People we spoke with had no complaints and no concerns about the way they were treated.

Staff we spoke with also told us they enjoyed working in the home, and felt supported with suitable training opportunities.