The Care Quality Commission (CQC) has issued warning notices to a Harrogate Care home for the elderly.
The CQC visited the Alexander Court Care home on Cornwall Road over three days, with five inspectors (18, 19 & 26 March 2014) and found cause for concern in how the home was being run.
Alexander Court is part of the Esteem Care group of care homes and also includes Banksfield Nursing Home in Preston, Brandon House Nursing Home in Leeds, Alt Park Nursing Home in Liverpool, Douglas Bank Nursing Home in Wigan and the Tudor Bank Nursing Home in Southport
The inspection was carried out due to concerns raised with the CQC by other professional agencies.
The warning notices are legal instructions to make urgent improvements and were given a deadline of 23 May 2014 to be carried out. Failure to comply with warning notices can lead to a range of actions from the CQC and can ultimately lead to the cancellation of a care home’s registration with prosecution of the manager or provider.
The home had previously been inspected on 18 Dec 2013 and met all the required standards. The Inspection report for this visit can be viewed here
A spokesperson for the care home has said that the problems are down to the loss of a number of resources over a short time period.
However, during the inspections in March 2014, the inspectors noted a number of concerns.
They observed an incident where a person had choked after being given the wrong food. Rather than receiving puréed food they had been given a meal that had lumps of potato. The nurse on duty had to use first aid and resort to a suction machine to dislodge the potato. The care plan clearly indicated this person required puréed food and this information was held in the kitchen.
During mealtimes it was noted that people were sat at the dining table for long periods. Although staff were present, one person was asleep with their head on the table – staff were present in this room no attempt was made to wake this individual and move them to a more comfortable place for over forty minutes. Four people were left at the dining room table for two hours before being assisted to move.
The inspectors also observed correct care being given.
Inspectors observed some staff on the nursing unit, explaining to people what was about to happen; during moving and handling for instance. Staff gave people choices; where people wanted to sit, what they wanted to eat for instance.
The report also noted that at that at mealtimes during the inspectors visits they saw that people who needed help were being assisted with their meals. One person said “The food here is nice that has never altered.” Another individual said “I like it here very much and am quite happy to be here. We have quizzes or TV or music. I could tell staff if I had any worries or any problem. I like the staff and have made friends here.” Another person was also asked what they were doing that day, they said “Nothing much, just TV, nothing else”
Inspectors also observed a member of staff providing positive reassurance and support to an individual who was distressed to which they responded positively to.
In summary the inspectors found:
- People were not always consulted before they received any care or treatment and the provider did not take into account their wishes.
- Concerns about the health and safety of people living at the home and took immediate steps to ensure people were safe. The provider has agreed to suspend admissions until we are satisfied that the service has made the required improvements.
- Information contained in people’s care records was inconsistent; which increased the risk of people receiving care which did not met their needs and wishes.
- Inconsistent recruitment processes and staffing arrangements placed people at risk of receiving unsafe care, particularly for those requiring nursing care.
- Poor auditing and monitoring meant that people’s health and safety was being placed at unnecessary risk of harm.
Warning notices were issued in respect of:
- Regulation 13 HSCA 2008 (Regulated Activities) Regulations 2010 – Management of medicines
- Regulation 21 HSCA 2008 (Regulated Activities) Regulations 2010 – Requirements relating to workers
The CQC instructed a range of outcomes to be met, including:
- Before people are given any examination, care, treatment or support, they should be asked if they agree to it
- People should get safe and appropriate care that meets their needs and supports their rights
- People should be given the medicines they need when they need them, and in a safe way
- People should be cared for by staff who are properly qualified and able to do their job
- There should be enough members of staff to keep people safe and meet their health and welfare needs
- The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care
Alexander Court Care Home, has said they accept the recommendations of the Care Quality Commission.
In a statement from the carehome:
Whilst the organisation has admitted responsibility, Alexander Court Care Home said that it was at fault as a result of a number of recent senior staff changes.
The home is working to make improvements and become compliant. The Service Providers are investing time and significant resources to ensure the home meets all regulations and is compliant according to the Essential Standards and the Health and Social Care Act 2008.
Himat Gami, a director of Registered Provider, Esteem Care, said: All concerns are related to record keeping and some staffing.
We have communicated with all friends and relatives and anyone with further concerns should contact us directly
We are working with and communicating with the CQC and local health care professionals to ensure the management and care of service users is maintained at a high level.
The care home remains under CQC enforcement until a further inspection is made to review the steps that have been made.