Alder House Care Home

Updated 1 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team included one inspector 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. The expert by experience for this home had experience of supporting people with health and social care needs.

Service and service type:

Alder House is a ‘care home.’ 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.

Alder House accommodates up to 60 people across three floors, each of which has separate adapted facilities. There is both stair and lift access in the building. At the time of the inspection, there were 52 people living there.

The service is legally required to have a registered manager in place. There was a registered manager in place.

Notice of inspection:

This was an unannounced inspection.

What we did:

We asked the provider to send us a provider Information return (PIR). A PIR is a form that routinely asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. We used this information as part of our inspection planning. We also offered the provider the opportunity to share information they felt was relevant.

Before the inspection took place, we gathered information known about the service. We considered notifications the provider had sent to us. A notification is information about important events which the provider is required to send us by law. We also considered any information received from the public and professionals. We were informed of a coroner outcome of ‘accidental death’, which had no formal recommendations for the service. We used this information to plan our inspection.

During our inspection, we carried out general observations of care and support and looked at the interactions between staff and people who used the service.

We spoke with seven people who used the service and ten relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with four care staff, one domestic staff and the registered manager. We spoke with two visiting professionals. We looked at the relevant parts of the care records of five people who used the service. We also looked at three staff recruitment files and other records relating to the management of the home. This included audits, policies and incident records. Following the inspection, the provider sent us further information that we required to make our judgements.

Updated 1 May 2019

About the service:

Alder House is a residential care home in Nuthall (Nottinghamshire). It is registered to support 60 people, over three floors. On the day of the inspection visit, there were 52 people living at Alder House.

People’s experience of using this service:

People told us that they felt safe. The service managed risks safely and there were enough staff available to support people. These staff were recruited safely, to ensure they were appropriate to work with people. The environment was managed safely, it was clean and odour free. The service followed good infection control procedures.

The service was effective in the way it supported people. People were supported in line with evidence based guidance to ensure their needs were met effectively. Staff had good knowledge of people’s needs and had received appropriate training. People were supported to have a balanced diet and those at risk of weight loss were given appropriate support to manage this. People spoke positively about the food they were given. Staff worked collaboratively within the staff team, and with outside health and social care professionals. This ensured people received effective multi-agency support. Those people who required support making decisions (under the Mental Capacity act), were given this support in their best interests.

Everyone we spoke to told us that staff were caring. We observed caring interactions throughout our inspection visit. Staff actively involved people with planning their daily routines and listened to their preferences. People were given privacy and treated with dignity.

Care was very personalised to people’s preferences. We found personalisation was the ethos behind the service, and one of its key strengths. Staff knew people’s needs very well, and care plan records supported new staff to also have this knowledge quickly. Historic complaints and concerns had been listened too. People said that they have not needed to complain, but have faith in the registered manager to listen to them if they did complain. Those people who approached the end of their life, were supported in a dignified, caring and personalised way.

The service was well led. There has recently been a new registered manager in post. Staff spoke positively about their approach and leadership. It was apparent that the ‘good’ service managed by the previous registered manager had not changed. There was a clear governance framework and staff were aware of different responsibilities. People, stakeholders, outside professionals and relatives were all consulted on how to improve the service. Feedback was relayed to staff teams, and particularly praised staff were given additional recognition.

Rating at last inspection:

The last report was published as ‘Good’ (4 August 2016)

Why we inspected:

We last inspected in August 2016, and the inspection was required to ensure the service was still ‘good’. We had no concerns which prompted this visit, and it was planned as part of our usual inspection schedule. We routinely inspect services rated as ‘good’. This is to ensure the service remains at a good level and care is safe. We had no concerns when we planned this inspection. It was planned in line with our usual timelines.

Follow up:

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk