Archived: Carders Court Care Home

Updated 28 January 2017

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 was an unannounced inspection and was conducted by two inspectors and an Expert by Experience on the 29, 30 November and one inspector on 01 December 2016. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert was experienced with people who were elderly and were living with a dementia.

During the inspection we spoke with 24 people who used the service, 11 visitors, 3 registered nurses, 14 care staff members, the Admiral nurse, a member of the laundry staff, the chef and two regional support managers.

Before our inspection visit we reviewed the information we held about the service. This included notifications the provider had made to us. We had received safeguarding information from the local authority prior to the inspection. This information caused us to bring the inspection forward.

We did not request a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. This was because we brought the inspection forward and the provider would not have had sufficient time to complete the PIR.

During the inspection we carried out observations in the public areas of the home and undertook a Short Observation Framework for Inspection (SOFI) observation during the lunchtime period on the unit for people living with a dementia. A SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

During our inspection we observed the support provided by staff in communal areas of the home. We looked at the care records for eight people who used the service and medication administration records for 13 people. We also looked at the recruitment, training and supervision records for four members of staff, minutes of meetings and a variety of other records related to the management of the service.

Updated 28 January 2017

Carders Court is a care home providing nursing and personal care for older people. It is situated in the Castleton area of Rochdale. The home is purpose-built, single storey and comprises of five separate houses, each with 30 single bedrooms. There were 135 people accommodated in the home at the time of the inspection. There is car parking to the front of the home and there are garden areas around each unit for residents to sit out in.

We last inspected this service in December 2015. The service did not meet all the regulations we inspected and were given requirement actions for keeping the home clean. At this inspection the home was much cleaner and the regulation was met.

The service had a 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 a 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 was not present for the inspection.

During this inspection we found five breaches in the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. You can see what action we have told the provider to take at the back of the full version of the report.

Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them, which included the contact details of the local authority to report to any incidents to. However, some of the plans of care did not contain sufficient information to protect people from possible harm. We also found some staff were not following the directions given in the plans of care, for example for people at risk of choking.

Some aspects of medicines administration were not safe. Some of the medicines records were not signed for and hand written prescriptions had only one signature, when they should for safety have two. Some staff who administered medicines, for example, agency nurses did not know who people were and a lack of photographs may mean that people who could not identify themselves could be given the wrong medicines.

The service did not always follow the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Two people who did not have the mental capacity to make their own decisions had been admitted at the care home and no best interest meeting had been arranged or application for DoLS had been submitted.

Supervision and appraisal with staff was not regular and did not give staff the chance to discuss their careers or training needs.

People who complained did not always receive a satisfactory answer.

Plans of care were not always kept up to date or had been entirely completed.

Records we asked for could not always be found.

We made a recommendation that the service look at best practice training for end of life care for all staff.

Meetings with people who used the service/relatives were not held regularly on all units.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities to help protect their health and welfare.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

The home was clean and tidy. The environment was maintained at a good level and homely in character. We saw there was a maintenance person to repair any faulty items of equipment.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business plan for any unforeseen emergencies.

People were given choices in the food they ate and told us it was good. People were encouraged to eat and drink to ensure they were hydrated and well fed.

New staff received induction training to provide them with the skills to care for people. Staff told us and staff files confirmed staff had undertaken sufficient training to meet the needs of people who used the service. The service were also ensuring all staff received refresher training following the induction process.

People who used the service and relatives said staff were kind and caring.

There was a range of activities people could attend if they wished to help keep themselves occupied.

There were policies and procedures available for staff to follow good practice.