The Adelaide is a local authority run care home for short term respite and reablement support. Reablement is a way of helping a person to remain independent by giving them the opportunity to re-learn or regain some skills for daily living that may have been lost as a result of illness, accident or disability. The home provides accommodation for up to 24 older people, including people living with a cognitive impairment, such as dementia. At the time of our inspection there were 12 people living at the home.
The Adelaide also provided a reablement service, for a limited period, in a person’s own home. This included personal care; help with activities of daily living, and practical tasks around the home.
The last inspection of the home took place on 23 August 2013 and no concerns were identified. However, an inspection of the community reablement aspect of the service between the 17 and 20 September 2013 identified breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We took enforcement action and required the provider to make improvements.
This inspection, which was unannounced and carried out on 24 and 26 June 2015, looked at both aspects of the services provided by The Adelaide. During the inspection we found the provider had completed all the actions they told us they would take in respect of the community reablement aspect of the service.
People told us they felt safe. However, not all risks to people using home had been identified, which could impact on their health and wellbeing. Risks relating to people using the community reablement service had been identified and were effectively managed.
The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. The MCA provides a legal framework to assess people’s capacity to make certain decisions, at a certain time. Although staff were aware of the principles of the MCA, they did not have access to sufficient information to enable them to understand the ability of a person living with a cognitive impairment, such as dementia to make specific decisions for themselves. We found the home to be meeting the requirements of the Deprivation of Liberty Safeguards. We have recommended that the provider seeks advice and guidance on adopting the latest best practice guidance in respect of mental capacity assessments for people living with a cognitive impairment.
There were suitable systems in place to ensure the safe storage and administration of medicines. All medicines were administered by staff who had received appropriate training. Healthcare professionals such as GPs, chiropodists, opticians and dentists were involved in people’s care where necessary. Staff were aware of, and responsive to, people’s needs and preferences as to how they wanted to be cared for.
People and relatives told us they felt the home was caring. Staff were sensitive to people’s individual needs, treating them with dignity and respect, and developing caring and positive relationships with them. People were encouraged to maintain relationships that were important to them. Staff also checked that people consented before supporting them.
People were complimentary about the quality of the food and were supported to have enough to eat and drink.
People were supported by staff who had received the appropriate training, professional development and supervision to enable them to meet their individual needs. There were enough staff to meet people’s needs. Recruitment procedures were safe and appropriate checks were completed before staff were employed.
Staff and the management team had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.
People and relatives told us the service was well-led. The provider had a clear vision for the service. Staff understood their role in delivering that vision and were encouraged to become involved in developing the service.
There were systems in place to monitor the quality of the service provided to people. The provider sought feedback from people using the service and their relatives in respect of the quality of care provided and had arrangements in place to deal with any concerns or complaints.