About the service:

Albion Court is a ‘care home’ that is registered to provide nursing or personal care to up to 89 people. There were 65 people living at the home on the days of the inspection.

Two days prior to the inspection the registered manager had left the service. An interim manager was in place and was working with the support of the provider’s regional manager and project manager. The provider is legally responsible for how the service is run and for the quality and safety of the care provided.

People’s experience of using this service:

• Some improvements had been made following our previous inspection in November 2017 to address the areas we identified as requiring improvement. However, we found that some areas had not been addressed. For example, at the last inspection we reported that menus did not fully reflect the cultural heritage of people and people’s individual needs were not met by the design and decoration of the home. At this inspection we found these improvements were still required.

• People were supported by staff to stay safe and who understood the need to ensure they consented to the care they received.

• People were cared for by staff who treated them with respect and dignity and encouraged them to maintain their independence.

• Staff received training that was appropriate to them in their role and supported them in providing care in the way people wanted.

• People’s consent was sought before providing support. Staff demonstrated a good understanding of the Mental Capacity Act 2005 and what this means for people.

• Staff liaised with other health care professionals to meet people’s health needs and support their wellbeing.

• The provider had quality assurance systems in place, however they were not fully effective as they had failed to ensure action had been taken in a timely way in some areas requiring improvements.

• Staff felt supported and said they could talk to management at any time, feeling confident any concerns would be acted on promptly.

• People spoke positively of service and staff said improvements had been made since the last inspection.

• The provider had a home improvement plan in place to develop the service further and they worked in partnership and collaboration with other key organisations to support care provision.

Rating at last inspection:

At the last inspection we rated Albion Court as ‘Requires Improvement’ (report published 21 February 2018). At this inspection the overall rating has remained as ‘Requires Improvement.’

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Enforcement:

Full information about CQC’s regulatory response to the more serious concerns found in inspections is added to reports after any representations and appeals have been concluded.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The inspection was unannounced and took place on 14 and 20 November 2017.

The home is registered to provide accommodation and nursing care for a maximum of 89 people. There were 76 people living at the home on the day of the inspection. Since the last inspection of Albion Court the provider has changed and the home was under new ownership. As a result of this change this will be their first ratings inspection of this location. Prior to the inspection the registered manager left the service and a new manager had been appointed and has submitted an application to register with CQC. 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.

People told us they felt safe with staff supporting them. People needs were met promptly. Both relatives and staff said that there were sufficient staff numbers to meet people’s needs and we saw staff responding to people in a timely way.

People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met.

People were supported by staff to have their medicines and records were maintained of medicines administered. Improvements were required to ensure medicines were stored at the correct temperature and to ensure GP instructions for administration were understood and followed.

The principles of the MCA (Mental Capacity Act) had been applied. Deprivation of liberty safeguarding (DoLS) applications had been made and reviewed appropriately. Staff spoken to understood the importance of gaining people’s consent to care but would benefit from additional training to increase their knowledge on their responsibilities under the MCA and DoLS.

Staff had received training so they would be able to care for people living in the home. There were good links with health and social care professionals and staff sought and acted upon advice received so people’s needs were met.

People and relatives also complimented the cleanliness of the home. Staff maintained good hygiene and used protective clothing when appropriate.

People’s nutritional needs were met. People were given a choice of meals, however people felt the menu of culturally appropriate food could be improved. People were supported with a choice of drinks throughout the day. The manager was working to improve people’s dining experience.

People liked the regular carers but people and relatives both raised concerns about agency staff and staff changes which meant the staff supporting people did not know them well. Relatives told us people were treated with dignity and respect and said they were made welcome by staff.

People told us they were involved in planning their care when they first went into the home but gave us mixed responses about whether they were involved in the continued planning and reviews their care. Care plans we viewed did not show us how people were involved in reviewing their care. People and relatives told us they could raise any issues should the need arise and they felt assured action would be taken.

People told us they enjoyed the activities on offer but would like more activities and exercise. Staff and relatives told us that activities could be improved to support people living with dementia. This was acknowledged by the manager who had arranged additional dementia training for staff.

The management team had systems in place to check the quality of the service provided. These systems had identified improvements needed to be made in some areas and an improvement plan was in place.

People, relatives and staff said that the service had been through a period of change. They ack