Background to this inspection
Updated
11 May 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.
This inspection took place on 6 and 7 January 2016 and was unannounced. The inspection was undertaken by two inspectors, one a pharmacy inspector and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
We contacted the local authority and local commissioners as part of our inspection to discuss information that had been shared with them about the service. We also looked at information we received from the service after our last inspection in February 2015, for example statutory notifications. These are events that the provider is required to tell us about by law in respect of certain types of incidents that may occur like serious injuries to people who live at the service.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We spoke with 10 people who used the service, eight visitors and two visiting health care professionals. We also spoke with the manager, two nurses, two senior care staff, four staff and one cook. We observed how staff interacted with the people who used the service throughout the inspection. We also observed a manager’s handover meeting.
The Pharmacist inspector reviewed the management of medicines including the Medicine Administration Record (MAR) charts for fourteen people. We also observed a nurse complete a medication round for six residents.
We looked at four people’s care records to see if these records were accurate, up to date and supported what we were told and saw during the inspection. We looked at four staff recruitment records. We also looked at records relating to the management of the service. These included minutes of meetings with people, service improvement plans, complaints records, stakeholder survey records and the provider’s self-audit records.
Updated
11 May 2016
Our inspection took place on 6 and 7 January 2016 and was unannounced. At our last inspection on 3 and 6 February 2015 we identified the provider needed to take action to improve the safe handling of medicines, ensuring safeguards were in place to protect people who did not have capacity from deprivation and protect people’s health when they had fragile skin. We found that the provider had made improvements in these areas and was now meeting the regulations.
Aldergrove Manor accommodates up to 70 people and caters for older people (Nightingale unit), older people with dementia (Haven unit) and people who have a physical disability (Phoenix unit) within three separate units. The service provides nursing care with nursing staff available 24 hours a day in Nightingale unit. There were 46 people living at the service at the time of the inspection.
The service had a manager, that while not registered had experience of managing care services. They had not applied for registration as a change of provider for Aldergrove was imminent at the time of the 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.
We found people’s medicines were not always well managed and there were limited occasions when people may not have received their medicines as needed; the manager did take action to address these issues during the inspection.
People told us they felt safe although they had mixed views about whether there was always enough staff available to meet their needs at some times of day. The manager and staff demonstrated awareness of what could constitute abuse and that matters of abuse should be reported in order to keep people safe. The provider had safe systems in place for the recruitment of staff.
People were supported to make their own decisions and choices by staff who understood and promoted people’s rights and worked in their best interests. People told us they experienced positive outcomes regarding their health, although there had been some occasions where the risks to people living with diabetes could have been responded to on a timelier basis. People said they received a choice of food and drink and we saw people were offered this choice, and were supported to eat and drink when required.
People who used the service and other people who had contact with the service said staff were kind and caring. We saw staff promoted people’s dignity, independence and gave them choice.
People told us, and we saw that they were not always able to access meaningful pastimes on a daily basis, although some said they were able to fill their time with activities that were enjoyable to them. Some people told us that they, or their families where this was their choice, were able to have involvement in how their care was provided. We saw that people had an individual plan, detailing the support they needed and how they wanted this to be provided.
The provider gathered people’s views in a number of ways, for example through the use of surveys, meetings and face to face discussion. We saw the provider had a complaints procedure that enabled people to raise concerns with these had been responded to appropriately. Staff had mixed views about the support they received some feeling they were not supported by the provider, although the majority were positive about how they were helped to do their jobs and the training they received.
People told us they were asked for their views and the provider responded to these. Regular audits were carried out by the provider. We saw that some issues identified by these were addressed.