Alston Court Residential Home

Alston Court Residential Home is registered to provide personal care for up to 11 people with a learning disability. This may include people who may be living with autism, dementia and physical disability. At the time of the inspection, 11 people were in residence.

The home is a adapted family home, located in the village of Kingkerswell and not far from the town centre of Newton Abbott. It was registered before the Registering the Right Support good practice guidance was issued. However, the service has been developed in line with the principles and values that underpin the guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with a learning disability and /or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them. The fact that Alston Court is larger than current best practice does not impact upon the care people receive.

People’s experience of using this service and what we found

People were safe. Staff received safeguarding training and understood their responsibility to keep people safe. They were familiar with the reporting process to be followed if any safeguarding issues were raised. Any risks to people’s health and welfare were well-managed. People were encouraged to be as independent as they were able, but plans were in place to mitigate risks so their independent activity was not compromised.

The number of staff on duty for each shift was sufficient to ensure each person’s care and support needs were met. Staffing levels also took account of planned activities and people’s needs when accessing the community. Pre-recruitment checks ensured new staff were employed safely. Checks included written references and a Disclosure and Barring Service check.

Medicines were well managed and administered by those staff who had been trained and were competent. People received their medicines as prescribed.

The assessment and care planning arrangements ensured each person’s care and support needs were met. Staff received the training they needed to be able to carry out their role well and were supported by the management team and the provider. New staff completed an induction training programme. People were supported to access the healthcare services they needed to maintain good health.

People received the food and drink they needed to maintain a healthy, balanced diet. Any preferences they had regarding food and drink were accommodated.

People were encouraged to retain as much choice and control of their daily lives and staff supported them in their best interests.

We have recommended that the management team and the provider increase their working knowledge of the Deprivation of Liberty Safeguards and the key requirements of the Mental Capacity

People were looked after by staff who were kind and friendly and listened to what they had to say. The staff team were fully committed to treating people who used the service as individuals. Each person received person-centred care and were included in making decisions, where possible about their daily life. Staff provided guidance to ensure safe decisions were made. The staff team were fully aware of each person’s specific needs. People looked well cared for.

The service delivered to each person was responsive to their specific needs. Each person was encouraged to be involved in the preparation of their care plan and having a say in how they wanted to be looked after. Plans were adjusted as and when needed so new care needs were accounted for, or in recognition that people wanted to be looked after in a different way. The service would endeavour to continue looking after people who became very ill or had end of life care needs and had started to work with people about any end of life wishes. They achieved this working in conjunction with family and healthcare professionals.

People were supported to be as active as possible and do the social activities they liked. People were able go out independently, or with staff support.

The service was well led. The registered manager and deputy had both worked at the service for many years and provided good leadership for the staff team. People were very much at the centre of all decision making. Their views and opinions were listened to and acted upon. The providers were both actively involved in the running of the service.

We have recommended that the provider implement a formal and recorded quality assurance system. This would ensure any shortfalls were identified and actions then taken to make the improvements required.

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

Rating at last inspection

The last rating for this service was Good (published 20 July 2017).

Why we inspected

This was a planned inspection based upon the previous rating.

Follow up

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

The service provides residential care for up to 11 adults with a learning disability. They may also have a physical disability, autism and a sensory impairment. Ten people were registered to live at the service when we inspected. Six people were resident on the first day as four were on holiday. The four people returned from their holiday on the second day we were there.

A registered manager was employed to manage the service. 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.

People told us they were safe and happy living at Alston Court and were looked after by staff who were kind and treated them with respect, compassion and understanding. All staff expressed a commitment to values of providing good care and to continue to improve the service. This was led from the front by the registered manager and provider.

People were in control of their care. People’s medicines were administered safely and they had their nutritional and health needs met. People could see health professionals as required. People had risk assessments in place so they could live safely at the service. These were clearly linked to people’s care plans and staff training to ensure care met people’s individual needs. People’s care plans were written with them, were person centred and reflected how people wanted their care delivered.

Staff knew how to keep people safe from harm and abuse. Staff were recruited safely and underwent training to ensure they were able to carry out their role effectively. Staff were trained to meet people’s specific needs. Staff promoted people’s rights to be involved in planning and consenting to their care. Staff followed the principles of the Mental Capacity Act 2005. This meant people’s human rights were upheld.

Activities were provided to keep people physically and cognitively stimulated. People were actively involved in how they wanted their day to be.

The provider and registered manager ensured there were systems in place to measure the quality of the service. People and staff were involved in giving feedback on the service. Everyone felt they were listened to and any contribution they made was taken seriously. There was close communication between the provider and registered manager but this was not recorded. They were looking of ways to record this and to ensure the service continued to meet people’s needs as they aged.