This unannounced inspection took place on 09 and 10 February 2015. Alistre Lodge is registered to accommodate 43 people who require personal and nursing care. There were 39 people using the service at the time of our visit. The home is situated close to St Anne's town centre. The service provider is registered to provide personal and nursing care, diagnostic and screening procedures and the treatment of disease, disorder or injury.
Although the home was compliant with the relevant fire regulations as stipulated by the local Fire Service, it was clear on the day of our visit that staff were unsure about the fire evacuation procedure. As a result this left people in the home in a potentially vulnerable position in the event of a fire. Staff were not fully aware of the fire evacuation procedure, as some had not read the updated documentation, and when questioned about it, were unable to give an accurate account of what they would do in the event of a fire. This is a breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 as the registered person had not met the requirements of the relevant Fire Safety legislation.
People’s views about the service they received were positive. Our observations and the information held with the records matched the positive descriptions that people who lived at the home had given us.
The systems and procedures operated at the home were designed to enable people to live their lives in the way they chose, depending on their ability. The care and support offered to people at the home was personalised and people’s dignity put first. The risks linked to people developing further health and social care problems were minimised as far as possible. The care provided was orientated around the person and took account of people’s assessed needs, preferences and choices.
The service and staff respected and involved people in the care they received. For example, all the care plans viewed showed the person’s choices and personal preferences. The care planning process had involved the person or their relative when they were written and their views were reflected in the plans. People told us they had input into the menus or activities at the home and we saw that the choice of meals was varied.
Staff members took into consideration the Mental Capacity Act (2005) for people who lacked capacity to make decisions. People’s mental capacity was assessed and there was information available in the service for the staff that helped them support a person with fluctuating capacity. We saw consistent approaches from staff with staff explaining to people before they undertook a care process, other staff gave the person information about the care and support they were in receipt of.
Staff were provided with effective support, induction, supervision, appraisal and training. The service had a system to manage and report accidents and incidents. When action plans were needed to monitor people's safety these were produced. The service had a quality assurance and, where appropriate, governance systems in place.
There were accountability systems in operation within the home. If care tasks or records were not completed, action was taken by the Registered Manager or management team to address the issues and ask people for a clear explanation as to why they had not undertaken their responsibilities properly.
We have made a recommendation about staffing arrangements. We recommend that the service consider current guidance and best practice on staffing arrangements and working hours.
There was a registered manager in place at the time of our inspection. 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. We last inspected this service on 19 August 2014 and the home was compliant with the regulations we checked during the inspection.