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Adelphi Residential Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 December 2018

We carried out a comprehensive inspection of Adelphi Residential Home on 13 and 14 September 2018. The first day was unannounced.

Adelphi Residential Home is registered to provide accommodation and personal care for up to 27 older people. Accommodation is provided over three floors. At the time of our inspection there were 23 people living at the home.

The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and we looked at both during this inspection.

At the last inspection on 6 and 7 June 2017, we found one breach of the regulations. This related to the provider’s failure to complete audits and checks to ensure the service was effective. We also made a recommendation about activities at the home. Following our inspection, the provider sent us an action plan and told us all actions would be completed by 4 July 2017.

At this inspection we found that the necessary improvements had not been made and the provider remained in breach of the regulation. The provider had not completed sufficient audits or checks of the service, to ensure that people were receiving safe, effective care. We also found a breach of the regulations relating to the safety and cleanliness of the premises. In addition, we have made recommendations about the need for legionella bacteria monitoring to be carried out at the home and for a programme of improvements to be put in place to update the home environment.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

People living at the home and their relatives were happy with staffing levels and told us staff were available to support them when needed. Risks to people’s health and wellbeing were managed appropriately.

We saw evidence that improvements had been made to activities at the home and most people were happy with the activities available.

Records showed that staff had been recruited safely and the staff we spoke with understood how to protect people from abuse or the risk of abuse.

Staff received an effective induction and their training was updated regularly. People who lived at the service and their relatives felt that staff had the knowledge and skills to meet people’s needs.

People told us staff were kind and compassionate and respected their right to privacy and dignity. We observed staff encouraging people to be independent.

People received support with nutrition and hydration and their healthcare needs were met. Referrals were made to community healthcare professionals to ensure that people received appropriate support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. Where people lacked the capacity to make decisions about their care, the service had taken appropriate action in line with the Mental Capacity Act 2005.

People told us that they received care that reflected their needs and preferences and we saw evidence of this. Staff told us they knew people well and gave examples of people’s routines and how they liked to be supported.

Staff communicated effectively with people. People’s communication needs were identified and appropriate support was provided. Staff supported people sensitively and did not rush them when providing care.

The registered manager regularly sought feedback from people living at the home and their relatives about the support provided. We saw evidence that the feedback received was used to develop and improve the service.

People living at the service, relatives and staff were happy with how the service was being managed. They found the registered manager and staff approachable.

Inspection areas

Safe

Requires improvement

Updated 4 December 2018

The service was not consistently safe.

We found that the lower ground floor area was unsafe, with equipment and substances that could cause harm not being stored securely. This area was also unclean.

A legionella risk assessment had not been completed and regular monitoring for legionella bacteria was not being completed.

Most people living at the home and relatives were happy with staffing levels. People’s risks were managed appropriately and their care documentation was updated when their needs or risks changed.

Effective

Good

Updated 4 December 2018

The service was effective.

People were supported appropriately with their nutrition, hydration and healthcare needs. They were referred appropriately to community healthcare professionals

People’s capacity to make decisions about their care had been assessed in line with the Mental Capacity Act 2005. People’s relatives had been involved in making best interests decisions.

Staff received an appropriate induction, effective training and regular supervision. People felt that staff had the knowledge and skills to meet their needs.

The home environment was dated in places and needed improvement.

Caring

Good

Updated 4 December 2018

The service was caring.

People liked the staff who supported them. They told us staff were kind and compassionate. We observed staff treating people with respect and kindness.

People told us staff respected their right to privacy and dignity. We saw staff involving people in everyday decisions about their care.

People told us they were encouraged to be independent. Staff told us they encouraged people to do what they could for themselves and we saw evidence of this during our inspection.

Responsive

Good

Updated 4 December 2018

The service was responsive.

Improvements had been made to activities at the home and most people were happy with the activities available.

People received individualised care that reflected their needs and preferences. Staff knew the people they supported well.

People’s needs and risks were reviewed regularly and care records were updated to reflect any changes. This meant that staff had up to date information to enable them to meet people’s needs effectively.

Well-led

Requires improvement

Updated 4 December 2018

The service was not consistently well-led.

The provider had not completed any checks or audits of the service to ensure that people received safe, effective care. The registered manager regularly audited and reviewed many aspects of the service. However, the audits completed had not identified or addressed the issues we found during the inspection.

The service had a registered manager in post who was responsible for the day to day running of the home. People who lived at the home, relatives and staff felt the home was managed well.

We saw evidence that the registered manager sought people’s views about the service and acted upon them.