The Albany Care Home

Updated 25 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Albany is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Albany is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed the provider’s last inspection report and action plan. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 4 relatives. Some people living in the home could not verbally give us feedback. As such we looked around the home and observed the way staff interacted with people. We further received feedback from 2 relatives. We looked at 7 people's care records and medicine administration records (MAR). We spoke with 12 members of staff including the registered manager, development and regulations director, nurses, carers, kitchen staff, domestic staff and maintenance personnel.

We reviewed a range of records relating to people's care and the way the service was managed. These included staff training records, 5 staff recruitment files, quality assurance audits, incidents and accidents reports, complaints records, and records relating to the management of the service.

Updated 25 August 2023

About the service

The Albany is a care home providing nursing and personal care to older people, some of whom are living with dementia. The service also supports people who are discharged from hospital and require support with rehabilitation prior to returning to their own homes. These are referred to as 'HUB beds'. The Albany is registered to accommodate up to 38 people with 14 of these being used as HUB beds. At the time of our inspection there were 36 people living at the service.

People’s experience of using this service and what we found

There had been some improvements made to improve people’s outcomes. However, the providers’ quality assurance processes were still not being used to drive improvement. We found some records were not completed correctly and the provider’s audits had not identified these shortfalls. Where shortfalls had been identified, there were either no clear timelines for the actions to be completed or the timelines were not met.

People told us they felt safe living at the Albany. Staff knew how to identify and report any concerns. Whilst the home was no longer using agency staff, we still received mixed feedback from people, relatives and staff regarding staffing levels against the demands of the HUB beds. On the day of the inspection, we saw staff were continuously busy and ensured call bells were attended to in a timely manner, even if it was just to let the person know they would be with them as soon as they finished what they were doing. Following the inspection, the provider sent us an update that the staffing levels would be increased following a discussion with the senior management team. The provider had safe recruitment and selection processes in place.

The home environment could be improved. The provider had already identified this and were working through an environmental refurbishment action plan to improve the home décor.

Risks to people's safety and well-being were managed through a risk management process. Medicines were managed safely, and people received their medicines as prescribed.

Staff access to supervisions and appraisals had improved and staff told us they felt supported. New staff went through an induction programme which included the provider’s own mandatory training as well as shadowing opportunities of experienced members of staff.

People had a pleasant dining experience which offered a variety of appetising homemade food choices available at times that suited people's preferences. The menu was overseen, and food prepared by an enthusiastic catering team who knew people’s needs very well. Staff supported people to maintain food and fluid intakes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had a particularly good understanding of when the principles of the Mental Capacity Act should be applied.

The home was well-led by a long-standing registered manager who was committed to improving people's quality of life. The registered manager knew the service well and had support from a deputy manager. There was a clear management structure and an established group of staff who worked well as a team. Staff worked well with external social and health care professionals.

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 August 2022). The service remains rated requires improvement. This service has been rated requires improvement for the second consecutive inspection.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced comprehensive inspection of this service on 24 and 31 May 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Albany Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.