We carried out a review of the data available to us about Alderwood L.L.A. Limited - Rushden 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 Alderwood L.L.A. Limited - Rushden, you can give feedback on this service.
This inspection took place on 15 January 2018 and was unannounced.
At the time of our inspection, the provider confirmed they were providing care to 5 people.
At the last inspection in October 2015, the service was rated Good. At this inspection we found that the service was now outstanding.
People and their family were involved in their own care planning and were able to contribute to the way in which they were supported. Care was completely centred and tailored to each individual. Systems were in place to identify what each person wanted to achieve, and how best to support them to do this.
People were supported to work towards and complete major achievements in their lives. This included educational, occupational and leisure activities as well as the development of their own independent living skills. The service was flexible and adapted to people's changing needs and desires, enabling positive outcomes for all concerned. People felt a part of their community, and were able to take pride in their achievements.
Staff were well supported by the registered manager and senior management team. The registered manager had a clear vision for the service and its development. Staff were passionate and dedicated to their roles and had belief in the ethos of the support they received, and that of the provider in general. Staff were innovative in their approach to support, and were enthusiastic about supporting people to overcome life’s hurdles.
There was a registered manager in post. 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.
Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and detailed risk assessments and behaviour management plans were in place to manage all risks within a person’s life. Staff were all confident in supporting people with complex needs and behaviours which may challenge.
The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Correct staffing levels were in place.
Staff induction training and mentoring was extensive and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Staff felt that training made them confident within their roles.
People's consent was gained before any care was provided. Families were involved in people’s care when appropriate. 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 support this practice.
Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes
The provider had systems in place to monitor the quality of the service as and when it developed and had a process in place which ensured people could raise any complaints or concerns.
Alderwood LLA Ltd Rushden provides accommodation, personal care and support for up to five people with a learning disability and autistic spectrum disorder. On the day of our inspection there were five people living in the service.
The inspection took place on 16 November 2015.
The service had a registered manager. 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 found a really positive, caring and progressive atmosphere within the service. People were placed firmly at the heart of the service and all aspects of care had been centred on them and their needs. There was lots of laughter and good humour, with kind and trusting relationships evident between staff and people. People were involved in the planning of their care and told us they felt included in discussions, being able to have their say at each step of the way. Staff were passionate about their work and driven by a desire to provide high quality care. They were flexible and adaptable, ensuring that people participated in their own care and achieved their full potential, helping them to lead a meaningful life, doing things that were important to them. The provider philosophy was that people should be able to access the best of everything in life and have ample opportunities to achieve their goals.
The service was led by a dedicated and impassioned registered manager, who was well supported by a strong and positive management structure within the provider organisation. The culture within the service was open, optimistic and uplifting; staff were proud to work for the service and wanted it to be the best it could. Staff and the registered manager were exceptionally well motivated and committed to their work; they faced up to challenges and used these to improve things. They had strong values and a shared vision, and strived to give people positive care experiences and provide high quality care.
Staff attended regular meetings, which gave them an opportunity to share ideas, and exchange information about possible areas for improvements to the registered manager. Ideas for change were welcomed by the registered manager and provider, and used to drive improvements and make positive changes for people. Quality monitoring systems and processes were used robustly to make positive changes, drive future improvement and identify where action needed to be taken. All staff told us they wanted standards of care to remain high and so used the outcome of audit checks and questionnaires to enable them to provide excellent quality care.
People felt secure in the service and we observed they were calm and relaxed in the presence of staff. Staff had a positive approach towards keeping people safe and demonstrated a strong awareness of what constituted abuse. They understood the relevant safeguarding procedures to be followed in reporting potential abuse. Staff were committed to managing fluctuating risk factors for people and had a good understanding of how to support them when they became anxious or distressed. Potential risks to people had been identified, and detailed plans implemented to enable them to live as safely and independently as possible.
Robust recruitment checks took place in order to establish that staff were safe to work with people before they commenced employment. There were sufficient numbers of staff available to meet people’s care and support needs and to enable them to do the things they enjoyed. People received their medication as prescribed. Safe systems and processes were in place to protect people from the risks associated with medication.
Staff received regular training, based upon best practice in autism, which provided them with the knowledge and skills to meet people’s needs in a person centred manner. They were well supported by the registered manager and senior management team in respect of supervision and appraisal which enabled them to remain motivated and responsive to people’s individual needs.
Staff sought people’s consent before they provided care and support. Where people were unable to make certain decisions about their care, the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. Where people had restrictions placed upon them, staff ensured people’s rights to receive care that met their needs was protected, and that any care and treatment was provided in the least restrictive way.
People were supported to access suitable amounts of good quality, nutritious food. A variety of meal options were available for people, which included specific health and cultural dietary requirements. We found people were encouraged and supported to participate in meal preparation as part of developing their life skills. Referrals to health and social care professionals were made when appropriate to maintain people’s health and well-being. Staff worked closely with other professionals to ensure people’s needs were fully met.
People had been supported to develop life skills and gain independence, using individually created development programmes. The support for this was provided by a highly skilled staff group, who shared a strong person centred ethos and were dedicated to helping people lead a fulfilled and enriched live. People and their relatives expressed their delight at the progress they had made since coming to the service, which was often far beyond the level of achievement they had previously hoped for. Staff used innovative ways to support people to move forward, adapting when their needs changed. They had a strong understanding of people’s interests and hobbies and accessed a wide range of activities that were tailored to people’s individual needs. People were actively supported to integrate within the local community, using local facilities to avoid social isolation. To facilitate this, the service had developed links with local colleges, libraries and local employers offering work experience.
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive to people's needs?
' Is the service well led?
This is a summary of what we found:
Is the service safe?
We found that the staffing ratio facilitated people to participate in activities of their choice, both within the home and the wider community. We found evidence to suggest that people enjoyed a good quality of life. One person told us, 'I like living here, staff are kind.' Another person told us how they were looking forward to going to work. We found that people were protected from potential abuse because staff understood their role in safeguarding the people they supported and staff ratios enabled them to effectively attend to people's support needs in a caring way.
Individual care plans and associated risk assessments were updated regularly and contained comprehensive, person centred detail to guide staff and ensure that people were protected from harm.
We found that there was a system in place to make sure that manager and staff learnt from events, including accidents and incidents, health and safety issues, complaints and concerns. This meant that the risk of harm to people was reduced and that the service was able to evidence its desire to improve.
Is the service effective?
We observed staff talking with and supporting people during our time in the home, we found that this was done with the person's privacy and dignity in mind. This demonstrated staff's awareness of people's individual support needs. It also reflected the support plans we viewed on the day.
Within the care files we saw that people or their families, where appropriate, had been involved with, and agreed with the particular care needs that had been identified for them. Care plans were pictorial in nature and showed that people had had their needs assessed prior to admission and again on a regular basis. We found staff had a good understanding of what people's care needs were and when they had changed.
Is the service caring?
We saw that people were happy with the care and support they received. We observed that people were offered support at a level which encouraged independence and ensured their individual needs were met. Staff were relaxed, friendly and courteous in their approach to people and interacted confidently with them. Records showed that people were encouraged to express their views about the quality of care in the home and were involved in planning their care, making decisions about their support and treatment, and how they spent their time.
Is the service responsive to people's needs?
We noted that people's wishes were respected by care staff and taken into account when making best interest decisions, gaining consent and planning care and support. Records supported that the service engaged effectively with other professionals in ensuring that all areas of health and well-being were maintained.
Is the service well- led?
We found that the provider monitored the quality of the service provided to people and acted upon the feedback they were given. This showed that the service had an effective management structure and was responsive to concerns, making efforts to drive on-going improvement.
We observed staff talking with and assisting people throughout the day, this was done with the peoples' privacy and dignity in mind and showed the staffs' awareness of peoples individual support needs.
We looked at the quality assurance questionnaires that were given to people recently, usually following a care plan review. People were asked to comment if they were satisfied with the services provided in the home and could add comments or return these anonymously if they wished. The feedback contained only yes and no comments, and although people were asked for comments did not include any.
On our tour around the home and gardens we saw people in a relaxed state, and undertaking activities. No one would speak to us directly or make specific comments for us to include in this report.
When we spoke with staff they were aware how to support people and this reflected the support plans we viewed on the day.
Overall we looked at a number of outcome areas covering consent and agreement to care, support plans, nutrition, medicines, the environment, and the recruitment process.
Care records detailed people's preferred routines and gave clear details of how staff should support people with various activities and tasks. We saw that comprehensive assessments of the risks to individuals and other had been undertaken with written guidance on how staff should support people safely to reduce these risks.
Alderwood LLA Limited Rushden was registered for Treatment of disease, disorder or injury as well as accommodation for persons who require personal care. As the Alderwood LLA Limited Rushden is a care home without nursing this regulated activity was not being provided. We discussed this with the nominated individual who stated they would apply to amend the registration. This inspection did not include treatment of disease, disorder or injury.