Archived: Alderton House

Updated 20 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned this inspection 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 comprehensive inspection took on 01 and 05 November 2018. One inspector carried out the inspection. We visited Alderton House on 01 November 2018 and requested feedback from people’s relatives on 05 November 2018.

Prior to the inspection we looked at information we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We had asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed this information and the report of our last inspection.

During the visit we spoke with three people who lived at Alderton House, the registered manager, the deputy manager, two senior support workers and a support worker. Before the visit we wrote to a number of healthcare professionals who the registered manager told us had had recent contact with the service. Two healthcare professionals replied and we have included their comments in this report. We also wrote to a number of relatives and four replied, we have also included their comments in the report.

Updated 20 December 2018

Alderton House provides accommodation and non-nursing care for up to ten people with a learning disability or autistic spectrum disorder. There were nine people living in the home at the time of the inspection. The tenth bedroom was being used for storage. Each person had their own bedroom in the house. There was a communal kitchen, dining room, and lounge and quiet room for people and their visitors to use.

This unannounced inspection took place on 01 and 05 November 2018.

At the time of the inspection there was a registered manager in place. 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.

At our last inspection we rated the service Good, with a rating of Outstanding in the area of Responsive. At this inspection we found the evidence continued to support the rating of Good overall. However due to the lack of staff and how this sometimes resulted in people not being able to attend their planned activities responsive has now been rated as Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. We have written this inspection report in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service has been developed 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

However, the service was in a large home which was larger than most domestic style properties and was registered for the support of up to 10 people. This is larger than current best practice guidance. The size of

the service having a negative impact on people had been mitigated in the following ways. The design of the building was such that it fit into its environment as it is in a residential road with other large domestic homes

of a similar size. There were nothing outside the building that may indicate it was a care home. Staff wore their own clothes and removed badges when in the community. People had a high level of autonomy over how they spent their time. People's support was built around them and this enabled people to live individualised lifestyles. There were numerous rooms that people could use in addition to their private space. The building did not feel overly busy or institutionalised.

People continued to receive a safe service. Staff protected people as far as possible from discrimination, abuse and harm. Risk assessments were in place and had been regularly reviewed so staff were aware of what action to take to reduce risks to people. There were enough staff to ensure that people’s needs were met. Recruitment checks were completed to ensure staff were suitable to work at Alderton House. People received their medication as prescribed. Accidents and incidents were monitored so that action could be taken to prevent a reoccurrence.

People continued to receive an effective service. Staff received training and support which gave them the skills and knowledge they required to do their job well. There was a detailed assessments and lengthy transition period when people moved into Alderton House to ensure it was the right place for them. Staff supported people to eat and drink the right food to maintain their health. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People continued to receive care and support from staff who cared about them. Staff were kind, compassionate and gave emotional support when needed. Staff respected people’s privacy and dignity. They knew people well and supported people to be as independent as possible including learning new skills. Staff welcomed people’s relatives and visitors.

People continued to receive a service that was very responsive to their needs. People and their families were fully involved in planning their care and support. Support plans were personalised and included information about what goals they wanted to achieve. People choose what activities they wanted to do and where they would like to go. People and their families were confident if they needed to complain it would be dealt with appropriately.

The service continued to be well-led, by a registered manager who provided good, hands-on leadership. People were put at the heart of the service and staff were motivated to provide them with a good quality service. They monitored all aspects of the service for quality and put actions in place to address any shortfalls. There was an open, person-centred culture. The provider sought the views of people, their relatives and staff and these views were taken into account to ensure continuous improvement. The service worked in partnership with organisations such as the local learning disability partnership to provide people with joined-up care.

Further information is in the detailed findings below.