Archived: Alma Residential Home

Below is a summary of what we found. The summary is based on our observations around the home during the inspection, speaking with the staff and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that the service was safe because the provider had reviewed their policy and procedures on Infection control which included recent legislation. The provider had developed a new system of quality assurance monitoring, cleaning schedules and spot checks regarding infection control. Staff had received refresher infection control training and senior staff had undertaken an in depth course so they could monitor staffs practice and protect the people who lived in the home from cross infection.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and a visiting relative, the staff and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We evidenced the service used the Deprivation of Liberty Safeguards (DoLS) to protect the rights of people who lived at the home. We spoke with the manager and senior staff who demonstrated their knowledge of the procedures to follow. We had received evidence that an application had been submitted following their concerns that a person's liberty was being limited to keep them safe. We found that people's mental capacity was assessed and best interest meetings were held according to legal requirements. We had confirmation that all staff had been trained in DoLS, in Mental Capacity Act 2005 and in safeguarding of vulnerable adults. We found risk assessments with clear action plans were in place to ensure people remained safe. There were sufficient numbers of suitably qualified, skilled and experienced staff employed for the purpose of carrying on the regulated activities. The care records that were kept were accurate, fit for purpose and regularly maintained.

Is the service effective?

People and a relative told us they were satisfied with the quality of care that had been delivered. The relative told us, "There is normally a calm atmosphere with the residents being relaxed, there are lots of different activities going on during the day, and they have outside entertainers who visit, these are well received. We saw that the delivery of care was in line with people's care plans and assessed needs. We found that the staff had received training to meet the needs of people who lived at the home. Training courses included dementia, diabetes, palliative care, mental health and Parkinson's disease.

Is the service caring?

We found that people who lived in Alma Residential Home were supported by kind and attentive staff. We observed staff interacting with people who used the service and noted how staff provided encouragement, reassurance and practical help. We saw staff helped people with their care and support, at mealtimes and during activities with patience and kindness. A relative of a person who used the service told us, , "The care workers are patient and very caring. My relative can be demanding of the care workers time, but they make sure they give her their time and reassurance'. They also told us 'People living here always look well cared for and staff know the residents individual likes and dislikes and care for them accordingly'.

Is the service responsive?

People's needs had been assessed before they moved into the home and their support plans were reviewed regularly to reflect any change in their needs. We saw that people's records included people's history, wishes and preferences and goals to be achieved. People and/or their representatives were involved with reviews of care plans and were kept informed of any changes. A relative told us 'The home keeps the family very well informed'. We spoke to the palliative care nurse and they told us 'The staff are very good at referring people they have concerns about, staff also follow any instructions given them about the individual care of a resident'.

Is the service well-led?

We found that there were policies and procedures that addressed aspects of the service in place, however these had not been regularly update. We found for example that the policy and procedures for Infection control were not up to date with the more recent legislation. The registered manager had not operated a comprehensive system of quality assurance or completed audits to identify any short falls in the management of the service. People and their relatives or representatives were consulted about how the service was run and annual survey questionnaires were sent and analysed. Staff told us they were able and encouraged to express their views and concerns they may have and were listened to. Complaints, incidents and accidents were appropriately recorded and action taken to reduce identified risks. Staff practice was regularly observed and supervised by the senior staff to identify whether additional training or refresher courses were needed.

We found that people were content and felt comfortable living in the home. People's comments included: 'Yes, I like it here' and 'The staff are very kind.' A relative who visits at least weekly said 'It is very good here, I do not have any concerns, it is a nice family atmosphere, the staff are marvellous! They are so patient and kind.'

Medication was found to be given as prescribed.

We found that care plans were up to date, and were specific to the person concerned.

People said that they enjoyed the food and there was 'seconds if you want it.'

We found that the provider had taken action to deal with issues raised about the environment, although this is still a work in progress.

We found that the home had robust procedures in place for staff recruitment.

People's views were obtained on an on-going basis, and we found that these were taken into account and used to make improvements in the home.

People told us they were satisfied with the service they received. They said, 'I like living here.' 'The staff do a good job.' 'There isn't anything I am not happy with.' 'I get all the help I need'.

We found that people or their representatives had been consulted about the care they received and had given their consent to their plans of care. People's health and personal care needs were met and they were given the medicines they needed when they needed them. Staff were supported and trained to provide safe and appropriate care to people who lived in the home. Suitable adaptations to the premises had not been made to meet the needs of people who were experiencing dementia.