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Where people were at risk of malnutrition appropriate risk assessments were in place and people were supported to maintain a good nutritional intake. Catering staff worked with care staff to identify those people requiring fortified diets. Care records showed people’s needs were identified and responded to in a person centred way. However, daily notes were not completed in detail to show how people spent their day. The last rating for this service was requires improvement with one breach of regulation.
Wherever possible, Inspectorate reports and grades are accessible from the housing-with-care pages on this website. Daily help, including personal care, is available on site and one or more meals are available daily in a dining room or restaurant. Additional facilities are also common – for example hairdressing salons, hobby rooms and gyms. Organised activities will focus on helping residents maintain their health and wellbeing. They inspect care services to ensure they are supporting peoples wellbeing; appropriately setup; properly planning out care; are well led; and effectively staffed, each criteria is given a grade out of 6.
Adel Grange Residential Home
We also found that the systems in place to monitor the quality of service delivery were not effective. The service is divided into two units with the second floor accommodating people who are living with dementia. The service is divided into two units with the second floor accommodating people who may be living with dementia.
The staff had access to supervision and felt they could ask for advice or support from more senior colleagues at any time. Harewood Court provides nursing and personal care for up to 40 people. The service is divided into two units with the second floor accommodating people who were living with dementia. At the time of our visit there were 34 people living at Harewood Court.
Care homes in Harewood
Staff respected people’s privacy and dignity and promoted independence, equality and diversity. People and their relatives were involved in the planning and delivery of their care. MHA is dedicated to providing some of the highest quality care and support to older people across Great Britain - and we're proud that this is reflected in our independent care inspection reports. We saw people had to wait for periods of time for their meals to be served and there were times when communal areas of the home were left unsupervised. Most staff were unable to tell us how they sought agreement to the care and support that was offered to a person who was not able to communicate verbally. If people were not able to give consent due to lack of verbal communication, staff we spoke with were not able to explain how they knew if people were consenting to care.
Staff demonstrated a good understanding of protecting vulnerable adults. They told us they were aware of how to detect signs of abuse and were aware of external agencies they could contact. They told us they knew how to contact the local safeguarding authority and the CQC if they had any concerns. They also told us they were aware of the whistle blowing policy and felt able to raise any concerns.
Cardinal Care Services Ltd
We have recently been able to open EAC Advice, a new 'housing options' advice service for older people. With a few exceptions, accommodation in a care home cannot be bought or rented like retirement housing. Think of them more like full-board hotel accommodation with 24 hour care available. A care home is a residential setting where a number of older people live, usually in single rooms or hotel-style suites, because they need regular or continuous access to care. Those run by private operators more often focus on lifestyle, with help and care services discretely available to buy if or when required.
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made. Deprivation of Liberty Safeguards records showed two people’s had expired and applications for renewal had not been made until after the expired date. There was a risk people could be being deprived of their liberty illegally. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme.
Care provided
Window restrictors were not in place on windows that opened wide enough for people to fall out of and risk assessments had not been undertaken regarding the use of them. This was a breach of Regulation 12 Safe care and treatment of the Health and Social Care Act Regulations 2014. You can see the action we have told the provider to take at the end of this report. There were not enough qualified, skilled and experienced staff to meet people’s needs. The staff and visitors we spoke with on the day of our visit told us they had no major concerns about the number of staff at the home. However, we found the one nurse on duty was called upon to deal with other issues whilst administering medication.
Where people lacked capacity, relatives, staff and other health and social care professionals were not always consulted and involved in making decisions in each person’s ‘best interest’. Oakhaven Care Home is a medium size residental home situated in Leeds, with capacity to house 24 residents. The person’s care plan and daily records did not show how many cigarettes they were smoking. The person’s preferences were not being met and their records did not contain enough information about the planning and delivery of support. On this inspection, the service has been rated as Requires Improvement. Providers should be aiming to achieve and sustain a rating of 'Good' or 'Outstanding'.
However, we found the provider had not protected people against the risk of premises and equipment. The provider’s disciplinary procedures had not always been followed when concerns had been raised about staff member’s fitness and ability to carry out their duties. Systems in place were not robust and records did not clearly show the actions taken in these circumstances to ensure staff’s practice was safe. Systems for assisting people to make decisions in line with the requirements of the Mental Capacity Act had improved.
We had raised concerns at our first visit regarding aspects of cleanliness and infection control and fire evacuation procedures; however, these had been addressed for our return visit. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. Breaches of the Health and Social Care Act Regulations 2014 were found during this inspection. You can see what action we told the provider to take at the end of this report. People were supported to eat and drink well and to maintain a varied balanced diet of their choice. Culturally appropriate food was provided for people; with a twice weekly Caribbean option on offer.
The certificates to show the home was maintained safely were available and in date. This comprehensive unannounced inspection took place on 3 and 10 October 2018. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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