Archived: Albany Care Home

Updated 9 November 2015

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.

This inspection took place on 1 September 2015 and was unannounced. This means that the provided did not know that we would be attending. A second day of inspection took place on 2 September 2015, and was announced.

The inspection team consisted of three adult social care inspectors and a specialist advisor.

Before the inspection we reviewed the information we held about the service. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. We also contacted the local authority commissioners of the service, the local authority safeguarding team and Healthwatch.

During the inspection we spoke to seven people who lived at the service and two relatives. We spoke with eight members of staff, including the regional manager, the acting manager, a nurse, senior care workers and carers. We looked at six people’s care records and 12 people’s medicine records. We reviewed six staff files, including records of the recruitment processes. We reviewed the supervision and training reports as well as records relating to the management of the service. We completed observations around the service.

Updated 9 November 2015

This inspection took place on 1 September 2015 and was unannounced. This meant that the provider did not know we would be visiting. A second day of inspection took place on 2 September 2015, and was announced. The service was previously inspected on 3 and 10 February 2015, and was not meeting three of the regulations we inspected.

Albany Care Home is a nursing home providing personal or nursing care for up to 38 older people, some of whom are living with dementia. At the time of our inspection there were 27 people living at the service.

The service had a registered manager. However, when we inspected we were told that the registered manager had been transferred to another service operated by the provider. There was an acting manager in place who was applying to become the registered manager.

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 not always safe. Medicine records were not always completed fully, which meant that it was not possible to see when medicine had been administered. There was no system for the management of controlled drugs, and no policy on supporting people who used ‘as required medicine’.

Where safeguarding incidents occurred the service did not follow its own policy and ensure that they were thoroughly and properly investigated. This meant that it was not possible to see whether allegations had been substantiated or remedial action taken.

Risks to people were not always properly assessed and documented. There was no central record of people’s support needs in emergency situations. The service monitored its staffing needs and this ensured that staffing levels were matched to the dependency needs of the people using the service.

The service had no system in place for monitoring people’s mental capacity or for making applications under the Deprivation of Liberty Safeguards (DoLS). This meant that there was a risk that support was being given without people’s consent.

Staff received training but did not always find this effective. Records of staff training were not always accurate.

People were offered food and drinks suitable to their dietary needs and preferences, and were supported with their food and nutrition where necessary.

The service treated people with dignity and respect. Some staff were kind and caring and engaged with people in a positive and meaningful way, but others undertook their work focusing on the task rather than the person.

Care plans were sometimes incomplete or contradictory, which meant that care did not always meet people’s individual needs. People did not have access to activities that were tailored to their abilities or preferences. There was a complaints procedure in place, and this was advertised at the service.

Audits took place but these did not always result in remedial action being taken or improvements in the service. Feedback from people and their families was not encouraged, and where it was received it was not always acted on. Staff did not always feel supported at the service.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.