Archived: Applewood House & Apartments

On the day of our 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.

The risk to people’s safety was reduced because staff had attended safeguarding adults training, could identify the different types of abuse, and knew the procedure for reporting concerns. Risk assessments had been completed in areas where people’s safety could be at risk. People had the freedom to live their lives as they wanted to. Staff were recruited in a safe way and there were enough staff to meet people’s needs and to keep them safe.

Accidents and incidents were investigated. Assessments of the risks associated with the environment which people lived were carried out and people had personal emergency evacuation plans (PEEPs) in place. People’s medicines were stored, handled and administered safely.

People were supported by staff who received an induction, were well trained and received regular assessments of their work.

The registered manager ensured the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. However there were a small number of best interest documentation that were not available within people’s support records. Staff ensured people were given choices about their support needs and day to day life. Deprivation of Liberty Safeguards had been applied for and where applications had been granted, appropriate safeguards were in place.

People spoke highly of the food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.

Staff supported people in a kind and caring way. Staff understood people’s needs and listened to and acted upon their views. Staff responded quickly to people who had become distressed.

People were able to contribute to decisions about their care and support needs. People were provided with an independent advocate, if appropriate, to support them with decisions about their care. Staff understood how to maintain people’s dignity. People’s friends and relatives were able to visit whenever they wanted to.

People’s care records were person centred and focused on what was important to them. Care records were regularly reviewed. People were encouraged to take part in activities that were important to them and were provided with the information they needed if they wished to make a complaint.

There was a positive atmosphere at the home. The registered manager had an ‘open door’ policy and welcomed people to talk with them. People spoke highly of the registered manager. The registered manager understood their responsibilities and ensured staff felt able to contribute to the development of the service. People who used the service were encouraged to provide their feedback on how the service could be improved.

There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

We spoke with three relatives and asked them for their views. We also spoke with the registered manager, two team leaders and one care support worker. We looked at some service records, the support files for three people and did a tour of the building.

We saw people had information available to them in easy read language that advised them and/or their representative, of their choices and rights in relation to their care and support.

We observed people were supported to access the community and to do activities of their choice. One person told us, 'We decide what we want to do when we wake up.'

Relatives told us they felt people were safe and had their needs met. Comments included, 'The communication has improved, and the staff I see appear knowledgeable and competent. The manager and team leaders are all very good.'

We found staff received relevant training and support that enabled them to carry out their duties.

We saw the provider had internal quality, monitoring and audit systems in place. People were asked for their views and wishes about the service they received on a regular basis.

As part of the inspection we spoke with three people who used the service and three relatives. We also spoke with the registered manager and three members of staff. We looked at service information, support records and documentation for three people.

People said they felt involved in their care and treatment and their consent was respected. A person we spoke with said, 'The staff always ask me things, they don't tell me, I have choices.'

People we spoke with told us they felt staff listened to and supported them in the way they wanted. Comments included, 'I meet with my key worker every month, we talk about what I have done, would like to do and what support I need.'

We found people received care and support that met their safety and welfare needs. We saw people were receiving the correct level of support as stated in their support plan.

We saw people engaged well with staff and were supported to participate in activities of their choice.

The relatives we spoke with talked positively about the service provided for their relative. Comments included, 'They (staff) provide a decent service, communication is good and I feel involved.'