Archived: Adderley House Residential

Updated 10 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 February 2015 and was unannounced.

The inspection team consisted of two inspectors 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.

Before the inspection we reviewed the information we held about the home. This included any incidents the provider was required to tell us about by law and concerns that had been raised with us by the public or health professionals who visited the service. We also reviewed information sent to us by the local authority who commission care for some people living at the home.

During the inspection we spoke with people living at the home. Some people had problems with their memory and were unable to tell us about their experiences of living at the home. Therefore, 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 a cook, a housekeeper, a senior care worker and two care workers. We also spoke with the registered manager who was retiring and the incoming new manager.

During the inspection we looked at the care records of four people who lived at the home and other records related to their care such as daily notes and food and fluid charts. We also looked at staff training, complaints and the quality assurance records.

Updated 10 July 2015

We inspected Adderley House Residential on 27 February 2015. This was an unannounced inspection.

The last inspection took place on 12 August 2014 when we found that the provider was not meeting the standards of care we expected. Care was not planned or delivered to meet people’s needs or to ensure their welfare. People were not protected against the risks associated with infections and systems to prevent detect and control infections were not effective. The design and layout of the service was not always suitable and the premises were not maintained to an adequate standard. There were not always enough staff to meet people’s needs. The provider did not have effective systems to assess and monitor the quality of service people received and there were no effective systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service. After the inspection the provider wrote to us to say what they would do to meet the legal requirements. At this inspection we found the provider had made many improvements to the care people received and was meeting all of the legal requirements.

The home is registered to provide care for 40 people. The home has bedrooms for people in the main house and a number of self-contained flats. There were 23 people living at the home on the day of our visit, 10 in flats and 13 in the main home. The home was registered to look after older people.

There was a registered manager at the home. 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, they were due to retire shortly and a new manager had been appointed and was working alongside the registered manager.

The provider had completed a staffing analysis and used a recognised tool to ensure they had enough staff to meet people’s needs. As a result they had increased the number of housekeepers. However, at times staff were not deployed in areas where people needed assistance.

The provider used safe systems when new staff were recruited. All new staff completed thorough training before working in the home and had regular meetings with their supervisor to discuss their work. However, refresher training for staff had not been kept up to date. Staff were aware of their responsibility to protect people from harm. Staff knew how to raise any concerns they had about people’s safety to their supervisor or the registered manager. However, they were not all aware of how to raise concerns directly with external agencies.

The home was clean and tidy and the registered manager attended infection control meetings with the local council to ensure they kept up to date with new guidance. Staff knew how to work to reduce the risk of infection. While some equipment did not meet infection control standards this had been recognised by the new manager and action was planned to replace this equipment.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. The new manager was aware of their responsibilities under the MCA and there was no one at the home who was deprived of their liberty.

There were appropriate systems in place to obtain, store and dispose of medicines. Staff had received training in handling and administering medicines and did so competently. People and their families, had been included in planning and agreeing to the care provided. People had an individual plan, detailing the support they needed and how they wanted this to be provided. People were offered choices in the care they received and their choices were respected. There was a lack of activities at the home and people told us they would like more to do as they found it dull at times. People had also not been supported to access local community facilities such as the library.

The provider had completed a number of audits around the home and we saw they were successful at identifying concerns and issues. A quality survey had been completed, however, the provider had not reviewed the results to identify if any action was needed.