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Apple Blossom Court Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 February 2018

This comprehensive inspection took place on 08 November 2017. Apple Blossom Court 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.

The home is registered to provide accommodation and personal care for a maximum of 16 adults with a learning disability. The home is a three storey, detached property located in a residential area of Wallasey, Wirral. It is close to local shops and transport links to all parts of Wirral, Chester and Liverpool. At the time of our visit the service was providing support to 15 people.

The care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. However, we saw that people with learning disabilities and autism using the service were able to live as ordinary a life as any citizen.

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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During our inspection, we identified a breach of the Health and Social Care Act 2008 in respect of Regulation 17 good governance. You can see what action we told the provider to take at the back of the full version of the report.

The service did not have effective quality assurance systems such as audits in place and other checks did not operate effectively to ensure people received a safe, effective, caring, responsive and well led service.

Monitoring information was not clear in regards to maintenance, people’s weights and daily checks that were meant to be carried out by the staff.

A formal, fully completed application process and checks in relation to criminal convictions and previous employment had been completed when new staff were employed. However we did not see evidence of any risk assessments being carried out on staff whose DBS checks identified past convictions.

We saw that monthly or weekly checks such as fire alarms, fire extinguishers, emergency lighting and water temperatures had not been regularly completed.

We looked at safety certificates that demonstrated that utilities and services, such as gas, electric had been tested and were safe. Fire evacuation plans had been reviewed and updated. Personal emergency evacuation plans (PEEPS) had been completed for all of the people who lived in the service

Staff said they felt supported and that they could approach the registered manager with any concerns, however there was no evidence of a formal supervision and appraisal process.

We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had been followed by the home. The registered manager told us about people in the home who lacked capacity and that the appropriate number of Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority.

People's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary. The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place and training to guide staff in relation to safeguarding adults.

The people living in the home were able to express themselves and were able to choose the way they spent their day and were taken to activities outside the home. Each of the people’s bedrooms had been personalised by them and those who were able to choose who entered their rooms and go in and out of the front door freely.

People had access to nutritious food and drink throughout the day and were given menu choices at each mealtime. These options had been chosen by the people who lived at Apple Blossom Court.

Care records and risk assessments were well-kept and up-to-date. Each person living at the home had a personalised care plan and risk assessment.

Inspection areas

Safe

Requires improvement

Updated 7 February 2018

The service was not always safe.

Monthly or weekly checks that were to be completed by the staff had not been regularly completed such as fire alarms, fire extinguishers, emergency lighting and water temperatures.

Parts of the home appeared shabby and some areas in the home looked dirty.

Safeguarding procedures were in place and staff knew what to do in the event of an allegation. People told us that they felt safe.

Effective

Requires improvement

Updated 7 February 2018

The service was not always effective.

The manager had not carried out any formal supervisions with staff.

It was unclear which of the people who lived at the home needed their weight monitored.

Staff understood and applied the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. The manager had made appropriate referrals to the local authority.

People were given enough to eat and drink and a choice of suitable nutritious foods to meet their dietary needs.

Caring

Good

Updated 7 February 2018

The service was caring.

Staff showed that they had a good relationship with the people they supported.

Confidentiality of people’s information was maintained.

People living in the home were consulted regularly and their opinions were valued.

Responsive

Good

Updated 7 February 2018

The service was responsive.

The complaints procedure was displayed in pictorial form and was service specific.

People who lived in the home had a support plan which appropriately reviewed and reflected their needs.

People had prompt access to healthcare professionals when required and this was fully documented.

Well-led

Requires improvement

Updated 7 February 2018

The service was not always well-led

The home did not have effective audits in place.

Daily checks were not completed appropriately.

The service had a manager who was registered with the Care Quality Commission.

The registered manager was a visible presence and staff said communication was encouraged.