We carried out a review of the data available to us about Almond Villas on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Almond Villas, you can give feedback on this service.
Almond Villas is a 'care home' which is registered to provide residential rehabilitation for up to 14 adults with complex mental health needs. At the time of our inspection there were eight people using the service.
People’s experience of using this service:
The registered manager had made improvements since our last inspection of 19 March 2018.
People using the service told us they felt safe. Staff had received training in safeguarding and knew their responsibilities to report any concerns. Relevant safeguarding and whistleblowing policies and procedures were in place to guide staff. Risks to people’s health and wellbeing had been assessed and were reviewed on a regular basis to keep people safe. Good infection control practices were observed throughout our inspection.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. All the people using the service had capacity and were not being unlawfully restricted. People had given consent to their care and treatment.
People who used the service felt staff knew them well. We saw staff had access to numerous mandatory training courses. The register manager confirmed other training courses could be accessed as required, to meet the needs of people using the service.
We received positive comments from people about staff. We observed interactions that were caring, kind and sensitive. Staff spoke about people in a compassionate manner. People were supported to purchase food and cook meals, if this was necessary. Staff advised people in relation to healthy eating.
Detailed, person centred care plans were in place. People confirmed they had been involved in the development of these and had signed to consent. We saw regular reviews of care plans and goals were undertaken.
We received positive feedback about the registered manager and the operation and oversight of the service. Audits and monitoring had improved. Team meetings were taking place that provided staff with updates about the home and its operation.
Rating at last inspection:
At the last inspection this service was rated requires improvement [published 3 May 2018].
Why we inspected:
We undertook this inspection based on the previous ratings of the service.
Follow up: We will plan a follow up inspection as per our inspection programme. We will continue to monitor the service and if we receive any concerning information we may bring the inspection forward.
Almond Villas is a ‘care home’ which is registered to provide residential rehabilitation for up to 14 adults with complex mental health needs. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is a detached property close to Blackburn town centre and is comprised of four three bedroomed flats, each having communal facilities including kitchens and two further self-contained flats for people to live more independently prior to living in the community. There is a communal kitchen to teach people cookery skills and further rooms for group support sessions or private meetings. At the time of this inspection there were 12 people accommodated in the home.
According to CQC’s records at the time of the inspection, there was a registered manager in place at Almond Villas. 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. However, at the start of the inspection we were told this manager had left the home in May 2017 without submitting an application to deregister as manager. The acting manager in post told us they had submitted an application to register with CQC and had an interview scheduled for 5 April to assess their suitability for the role. The acting manager told us they had worked at Almond Villas for 17 years and were therefore familiar with staff and practices within the home. As the acting manager was also responsible for two other homes owned by the provider in the Blackburn area, they were supported in the running of these services by an acting deputy manager.
During this inspection, we identified one breach of regulations. This was because the systems and processes to monitor the quality and safety of the service were not sufficiently robust; this had led to the shortfalls we identified during this inspection.You can see what action we told the provider to take at the back of the full version of the report.
Although audits were in place, the audit in relation to care plans had failed to identify that some care records and safety assessments had not been reviewed or updated since the initial 3 month trial assessment period. There was no evidence that the provider had undertaken any monitoring visits since the last inspection and required actions had not been completed since the infection control audit conducted by the local authority in September 2017. In addition, people who lived in the home had not been offered the opportunity to complete a survey in order to give feedback on their care since September 2016.
People told us they felt safe living in Almond Villas. They told us staff were always available to support them in the activities they wished to do. People were enabled to make their own decisions and told us staff always promoted their independence. During the inspection we observed staff were caring and respectful in their interactions with people who used the service.
Robust systems were in place to ensure the safe handling of medicines. People were supported to take responsibility for their own medicines whenever possible.
The home was clean and well maintained. However, we have made a recommendation in relation to infection control.
Systems were in place to ensure staff were safely recruited. People who used the service told us staff provided the right level of support to meet their needs and to achieve their rehabilitation goals.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Where necessary, people were supported to access advocacy services to help them express their views and opinions about their care arrangements.
Staff told us they received the induction, training and supervision they needed to be able to carry out their roles effectively. They told us they felt valued and respected by senior staff in the service.
Staff demonstrated a commitment to providing people with equal opportunities and ensuring individuals received the support they needed to meet their diverse needs. The ethos of the service was that people should be provided with high quality, person centred care.
People who used the service were encouraged to participate in activities which met their interests and helped to promote their health and well-being. People were also supported to keep in contact with friends and family.
Records we reviewed showed that, where necessary, people were provided with support from staff to attend health appointments. People were also supported by staff, as far as possible, to maintain a healthy diet.
The acting manager promoted a culture where staff were able to report any incidents which occurred in order to ensure lessons could be learned. They were also committed to the greater involvement of people who lived in the home and staff in the way the service was run.
Almond Villas is registered with the Care Quality Commission to support up to fourteen adults with mental health needs. The property is close to Blackburn town centre and is comprised of four three bedroomed flats, each having communal facilities including kitchens and two further self-contained flats for people to live more independently prior to living in the community. There is a communal kitchen to teach people cookery and further rooms for group support sessions or private meetings. There are currently thirteen people accommodated at the service.
We last inspected this service in June 2014 when the service met all the regulations we inspected.
The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who used the service said they felt safe at this care home. Staff had been trained in safeguarding topics and were aware of the need to report any suspected issues of abuse.
Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults. There were sufficient staff to meet people’s needs.
We found the ordering, storage, administration and disposal of medication was safe.
There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities to help protect their health and welfare.
People told us they were encouraged to plan their menus, shop for their food and cook their meals with support from staff when required. Some people told us they were proud of the skills they were learning.
New staff received induction training to provide them with the skills to care for people. All staff were well trained and supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.
The registered manager was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.
There were systems to repair or replace any broken equipment and electrical and gas appliances were serviced regularly. Each person had an individual emergency evacuation plan and there was a business plan for any unforeseen emergencies.
The home was warm, clean, well decorated and fresh smelling. People who used the service were responsible for cleaning with staff support. People made good use of the covered seating area in the garden.
We saw that independent living was the aim of the service and how, on the day of the inspection, one person was nearing that goal.
We observed there was a good interaction between staff and people who used the service. We observed the good relationships staff had formed with people who used the service and how they responded well to any questions or advice people wanted.
We observed that staff were caring and protected people’s privacy and dignity when they gave any care. The care was mainly around people’s mental health needs but we did not see any breaches in people’s confidentiality.
We saw that the quality of recovery plans gave staff sufficient information to look after people accommodated at the care home and were regularly reviewed. People agreed to the restrictions placed upon them to help them get better.
We saw that people who used the service were able to attend meetings, 1 – 1 sessions and activities to gain their views. Professionals were asked for their views in the way the service was managed. Staff were encouraged to participate in how the home was run.
Policies and procedures were updated regularly and management audits helped managers check on the quality of the service.
Was the service safe?
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. People who used the service said, "I can complain to my support worker if I had any concerns but I don't have any. Everything is fine", "I go home on Sundays. If I had any worries I could talk to my family. I also have a social worker I can talk to" and "I can complain to my key worker. I have no complaints but she would listen to me". This reduced the risks to people and helped the service to continually improve.
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one.
The service was safe, clean and hygienic. There were policies and procedures for the control of infection. Three people who used the service told us, "We keep our rooms clean and tidy. Staff will help us if we need them and check up on us, but I can do it on my own", "The home is kept clean and tidy but we do most of that ourselves with support" and "I have a nice room. I keep the room clean and tidy because I cannot stand mess. The staff would support me if I needed help. I do my laundry every Thursday".
Was the service effective?
People's health and care needs were assessed with them if possible, and they were involved in writing their plans of care. Three people who used the service told us, "The goal is to become independent. Staff support me to take my medication. I talk to the staff and they always make me feel better. They always talk to me about my care", "They discuss my care with me. I can say what I want or hope to happen" and "They talk to us regularly about our care. They support us in what we want to do and achieve".
Specialist dietary, medication and community support needs had been identified in care plans where required. Most people were younger adults and did not require any specialist equipment.
The service helped people with mental health problems to recover and if possible achieve independent living. Three people who used the service told us, "They help us become independent. Cooking skills and things like that", "They are helping me to become more independent again. I hope to be able to be more independent in the future" and "I am still a little nervous about doing some things but staff are helping me learn to cope". Other people who visited the home for a meeting had already moved to more independent homes. The care service was providing an effective recovery program.
Was the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. There was a friendly atmosphere within the home and we observed that staff chatted to people who used the service throughout the day. Three people who used the service told us, "The staff are very good. They are all supportive and none of them are fierce", "It is good here. The staff are very nice to me" and "I think it is going all right. I am learning to stand on my own and I have a really good relationship with the staff. The staff have been really good to me".
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People who used the service were encouraged to provide as much information about their past lives and what they liked or did not. This information gave staff the knowledge to treat people as individuals.
People lived in a comfortable environment and were able to personalise their rooms to make them feel more at home. Three people told us, "I have a nice room and I have made it suitable for me. I like listening to my music", "My room is ok. The areas we all sit in are good as well" and "Our rooms are good and we can put our own things in them. The part I live in is good and we have our own kitchen".
Was the service responsive?
People completed a range of activities in and outside the service regularly. Each person had their known hobbies and interests recorded. One person had returned from doing his personal shopping. Other people who were able came and went as they pleased. On the day of the inspection there had been a meeting and people from another house had visited. They told us they were happy and enjoyed the trips and activities. One person was very involved in the local gym and told us it was his ambition to become a fitness trainer. Another person said, "I go to the gym, swimming and walking with staff. On Monday I do my shopping and during the week I get visits from my social worker and community psychiatric nurse. There is plenty to keep me occupied and I have just been on holiday. It was brilliant".
The registered manager and key staff held regular meetings with people who used the service. There was a staff meeting held at least once a week for various grades. Staff were able to voice their opinions. We saw that results from questionnaires had led the service to provide extra staff or improve the environment. The service produced a newsletter called 'The Voice'. With the agreement of people who used the service their achievements and activities were recorded as was useful information and some staff profiles to explain to people what their role was.
Was the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. There was a system for providing information to other providers in an emergency.
The service had good quality assurance systems. The registered manager undertook regular audits of the service. Records seen by us showed that identified shortfalls were addressed promptly and as a result the quality of the service was continually improving.
A staff member we spoke with said, "I like working here. I like staff training and teaching people how to be person centred. This should help ensure that people get the best service and care. We are well supported and the managers are approachable".
People spoken with told us they were happy with their care and support and said they were treated very well by the staff at Almond Villas. They commented, "I find it good here they are very caring people' and 'I have nothing bad to say about this place'.
People told us they enjoyed the food made at Almond Villas. Comments included, "We cook our own food here' and 'We have a healthy eating group where some of us cook meals together'.
All of the staff had achieved a recognised qualification in care and in mental health awareness, which would help them to look after people properly.
People told us there were sufficient staff to look after them. They made positive comments about the staff team. One person said, "They are really good here'.
People told us they were always consulted about the quality of the care and support they received. They said, 'We have a care review every two weeks and they ask us how things are' and 'We get a questionnaire to tick every two weeks so we can leave our comments'.
We found records required to be kept to protect the safety and wellbeing of people who used the service were accurate and up to date to ensure people's needs were fully met.
People told us they had no concerns about their care and support. They said they were encouraged to be as independent as possible; A person told us, 'They're helping me with a lot here'.
Staff had received training on safeguarding vulnerable adults and had access to appropriate policies and procedures. People using the service told us they were able to voice any concerns about the service to a member of staff and they felt confident appropriate action would be taken.
Suitable arrangements were in place to handle and manage medication. Checks were carried out on a regular basis to ensure medication was handled correctly and safely.
Three people told us there were sufficient numbers of staff on duty to meet people's needs. People made complimentary comments about the staff team. They also told us, 'This is a really good place and the staff help us a lot'.
Three people told us that they were being consulted about their opinion of the service. They told us they could talk about any issue concerning the home and were confident the manager and staff would listen and act if necessary.