We carried out a review of the data available to us about Apple House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Apple House, you can give feedback on this service.
We found the following examples of good practice.
People, staff and visitors were protected from risks of infection by robust and up to date policies and procedures. Visitors completed a health questionnaire, had their temperature recorded and were asked to complete a rapid COVID-19 test, which provided a positive or negative test result within 30 minutes. The home had a garden pod where rapid tests were completed.
The home was visibly clean and hygienic. Staff used cleaning products recommended by the local authority. Daily cleaning schedules included frequently touched surfaces such as handrails and door handles. Regular cleaning audits were conducted to ensure safety standards were maintained.
The home had a good supply of Personal Protective Equipment (PPE) which was audited weekly. Staff were observed wearing this correctly. Staff had received external training in how to put on and take off PPE and posters were available in the home as a reminder. Competency checks helped ensure a consistency of approach and the latest government guidelines were followed.
The home had supported people and staff to participate in the government’s COVID-19 testing and vaccination programme. Staff had been trained to complete COVID-19 testing. Consent had been sought appropriately when required. Where people could complete the testing independently, they were given the opportunity to do so.
People and staff were encouraged to socially distance within the home. People demonstrated a good understanding of what they needed to do and why to keep themselves and others safe. The home had received positive feedback from people, relatives and staff who were surveyed on infection prevention and control (IPC) practices during the pandemic.
The home recognised the importance of supporting people’s mental wellbeing and had worked creatively with people, their relatives and relevant health care professionals to maintain this. Staff had regular welfare checks and were assessed to determine if they were at any greater risk of infection from COVID-19. Where additional support needs were identified reasonable adjustments were offered.
The inspection was unannounced and took place on 27 February and 1 March 2018. At the time of this inspection there were four people living at the home.
There was a registered manager in post who had worked at the home for many years. 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.
Overall, people received a high standard of care and support at Apple House.
The registered manager and directors had been responsive to meeting people’s needs. Relatives and a healthcare professional provided very positive feedback regarding the care provided at the home. People were involved in developing their care plans and informing staff about how they wished to be supported. Staff responded promptly to people’s changing needs. Staff utilised their detailed knowledge of people’s needs and preferences to ensure people were able to continue taking part in activities that were important to them.
People enjoyed a range of activities that were arranged communally and individually, based on people’s own choice.
People were supported to exercise choice and empowered to take calculated risks and have control over their lives. People were actively involved in the local community and supported to meet their social and spiritual needs.
The registered manager had good systems to make sure that the environment and the way people were looked after were safe. Risk assessments had been completed ensuring care was delivered safely with action taken to minimise identified hazards. The premises had also been risk assessed to make sure the environment was safe for people.
Staff had been trained in safeguarding adults and were knowledgeable about the types of abuse and how take action if they had concerns.
Accidents and incidents, although uncommon, were monitored to look for any trends where action could be taken to reduce chance of their recurrence.
Sufficient staff were employed at the home and staffing was planned flexibly to meet the needs of people accommodated.
No new staff had been recruited to the service since the last inspection but recruitment policies and procedures were in place, should the service need to recruit more staff.
Medicines were managed safely.
The staff team were both knowledgeable and suitably trained.
Staff were well supported through supervision sessions with a line manager, and an annual performance review.
Staff and the manager were aware of the requirements of the Mental Capacity Act 2005 and acted in people’s best interests where people lacked capacity to consent.
The home was compliant with the Deprivation of Liberty Safeguards, with appropriate referrals being made to the local authority.
People were provided with a good standard of food and were fully involved in planning menus and what they wanted to eat.
Staff had good morale and knew people’s needs. People were treated compassionately.
There were complaint systems in place and people made aware of how to complain.
Should people need to go into hospital, systems were in place to make sure that important information would be passed on so that people could experience continuity of care.
The home was well led. There was a very positive, open culture in the home.
There were systems in place to audit and monitor the quality of service provided to people.
This routine comprehensive inspection took place on 29 and 31 July 2015. The first day was unannounced.
Apple House is a care home without nursing for up to four adults with learning disabilities. There were four people living there during our inspection. The home is a semi-detached house undistinguishable from other houses on the street, with a garden to the rear. Accommodation is in single bedded rooms on the ground and first floors, with stairs to get to the first floor. The garden at the rear has a patio with steps leading to a large, partially shaded lawn. Parking for visitors is on the road outside.
There was a registered manager in post, as required by the home’s conditions of registration. 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.
People found the staff very kind and supportive. Staff treated people with kindness and respect and showed concern for their wellbeing in a meaningful way, acting promptly if they were distressed or in pain.
People, their relatives and health and social care professionals were positive about the care and support received. Staff knew people well and were familiar with the support they needed, as set out in their care plans. People regularly met with staff to review their care and support. Staff ensured they understood the information they were given and kept their relatives informed of any changes or concerns.
A person living with chronic health conditions was supported to understand these. They were concerned about plans for their funeral and the registered manager had supported them to develop a funeral plan.
The registered manager was concerned to challenge any negative and judgemental perceptions of people. They developed the approach of the staff team to ensure that person-centred practice was sustained. The registered manager and provider maintained close oversight of the home, to ensure that good practice was maintained.
Risks were managed appropriately with a view to promoting people’s independence and minimising restrictions. Staff understood their responsibilities as regards safeguarding adults. They were aware of how to blow the whistle about poor practice to outside agencies, but felt they could approach the registered manager with confidence that they would act on any concerns raised.
Wherever possible, people were supported to make decisions for themselves. When people could not make decisions, staff followed the requirements of the Mental Capacity Act 2005. The home met the requirements of the Mental Capacity Act 2005 in relation to the deprivation of people’s liberty.
People were involved in the day-to-day running of the household, including choosing, shopping for and preparing meals. Whilst their food preferences were respected, they were encouraged to make healthy food choices. People were also meaningfully involved in decisions about how the home was run, including the staff recruitment process.
There was a stable, motivated, safely recruited staff team. They received regular training and supervision and had the skills and knowledge to perform their roles effectively. Sufficient staff were on duty to help people stay safe and support them as needed. People regularly participated in activities they enjoyed, both at home and in the wider community.
Medicines were managed safely, although there were no facilities for the storage of controlled drugs should these ever be needed.
The premises were kept clean and in good repair.
There had been no complaints in the past year. Relatives were aware of how they could raise concerns and people were regularly reminded about how they could make a comment or complaint. The registered manager agreed to update the complaints policy to state who any unresolved complaints should be referred to, and to reflect the role of CQC.
The home had a homely, informal, open culture that supported people to have active lives and make decisions for themselves wherever possible, with freedom to express their views and change their minds.
People were very familiar with the contents of their care records which were individualised and up to date. The records contained a great deal of personalised information about the House and they contained clear guidance for staff regarding the best ways to provide care and support. This meant the provider had ensured that staff knew the ways to provide support that met people's needs.
The people we spoke with told us that they had choice about how they spent their time and they told us about the many activities they participated in. People said the staff supported them to decide what their goals and aspirations were and then to formulate plans to support them to achieve these.
Relatives told us that people's independence was encouraged by the staff who were well trained. This meant they had confidence in the staff and management of the home to provide the care and support their relative needed.
They told us that they liked living at Apple House and the staff were 'alright'. They said that their privacy and dignity were upheld and they received all the support and advice they needed. People told us they were involved in making decisions about how they wanted to be helped. They said the staff made arrangements for them to see healthcare professionals when necessary.
People told us that where the home was situated was nice because they were near shops and other places they could go. They said their bedrooms, other rooms in the home were comfortable and it was well looked after. They told us that they met with their key workers and as a group living in the home to talk about how the home was run and how it could be improved.
We were able to speak with two staff who worked in the home about their training and the support they received from their managers. They told us that they felt their training gave them the skills and confidence to look after the people living at Apple House.
We spoke on the telephone with relatives of two of the people living at Apple House. We also contacted a community nurse and two care manager/social workers who visited people living there. This was in order to obtain their views about the quality of care and support people received. They all told us that they were satisfied with the service the home provided.