Villa Adastra

We found the following examples of good practice.

People were well supported by staff to maintain contact with their family and loved ones. The service facilitated in-person visits that minimised the risk of infection spread. People could choose to see their relatives with screen protection in a dedicated visiting area or sit with them to have physical contact that complied with national guidelines for care homes. Relatives were required to undertake Lateral Flow Device (LFD) COVID-19 tests before the visit commenced. People had been supported with video calls when visiting was not possible.

Staff wore Personal Protective Equipment (PPE) when undertaking any personal care and around the home; this was disposed of safely. Staff supported people sensitively and carefully to ensure social distancing guidelines were adhered to in a way that protected them and others at the home.

The home was clean and hygienic throughout. A structured cleaning schedule was in place and cleaning regimes were adhered to so that all areas of the home were cleaned effectively. Cleaning audits were regularly undertaken to ensure that the home prevented the risk of the spread of infection.

Risk assessments had been carried out with people and staff to identify those individuals who were more vulnerable of exposure to COVID-19.

There were comprehensive infection prevention control policies and procedures in place to support staff with visiting arrangements and cleaning protocols. The provider had a detailed contingency plan in place that could support staff in the event of an outbreak of COVID-19.

Villa Adastra is a residential care home. There were 33 people living there at the time of the inspection. The service specialises in providing care to older persons who are living with dementia, some of the people were also living with a range of care needs, including arthritis, diabetes and heart conditions. Some people needed support with their personal care and mobility.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

People’s experience of using this service:

Staff had a good understanding of the risks associated with the people they supported. Risk assessments provided further information for staff. People were protected from the risks of harm, abuse or discrimination. One person told us, “They check on me every two hours at night, so I feel safe.”

People were supported to receive their medicines when they needed them. There were enough staff working to provide the assistance people needed, at times of their choice. One person told us” It’s good at night to have someone to call on.” Recruitment procedures ensured only suitable staff worked at the service.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. For example, one person told us they liked the way they could continue to look after, “All my own tablets.” People's health and well-being needs were met. People said they liked the meals. One person told us they appreciated the way, “The food’s nice and hot.” People received support from staff to eat and drink when needed.

Staff received training which enabled them to deliver the care people needed. One person said about the staff, “Oh yes they’re all trained.” Staff received appropriate support from the registered manager and their team.

People were cared for by staff who knew them well. One person told us, “They try to do it in the way that suits me.” Staff understood people’s needs, choices and histories and knew what was important to each person. People were treated with kindness, respect and understanding.

People received support which was person-centred and met their individual needs, choices and preferences. People’s hobbies and interests were included in their support to ensure their well-being needs were met. Complaints had been recorded, investigated and responded to appropriately.

The registered manager and his management team were well thought of and supportive to people and staff. They had a good overview of the service. There were systems to assure quality and identify if improvements to the service were needed. The management team were open to new ideas to further improve service delivery.

Rating at last inspection:

Good (report published 28 June 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

A registered manager was 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.

Some infection control procedures were not followed consistently by staff. This meant that people were not always protected by the prevention and control of infection. We identified this as an area of practice that needs to improve.

People told us they felt safe and that there were adequate numbers of staff to meet their needs. Staff had a good understanding of how to protect people from abuse and knew what their responsibilities were if they had safeguarding concerns. Staff were also aware of the providers whistleblowing policy. People received their medicines safely and there were robust procedures in place for storing, administration and disposal of medicines.

People said they had confidence in the staff, one person said “I can’t fault the staff, they know what they are doing.” Staff recruitment and induction procedures were robust and ensured that staff had the knowledge and skills they needed to care for people living at Villa Adastra. Staff were well supported and had received additional training and support in caring for people living with dementia as well as other training specific to the needs of people they cared for such as training in Parkinson’s disease and managing behaviour that could be challenging.

Staff understood their responsibilities with regard to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and acted appropriately to seek consent from people, to assess their capacity and make best interest decisions were needed.

People told us the food at Villa Adastra was good. One person said “There’s always a choice of meat and vegetarian meals and there is always pasta available.” There was an extensive menu that repeated over four weeks and staff had good knowledge of the dietary requirements and preferences of individuals. People’s views on the food were actively sought and where people had complaints actions were taken to improve the standard. We saw that people were offered choices and supported to be as independent as possible when eating and drinking but received support when they needed it.

Staff had developed good links within the local community and a visiting health professional told us “They are very good at making early referrals, and communication is good.” People were supported to access the health care services they needed and staff communication was effective in ensuring that changes to people’s needs were identified and acted upon. Staff knew the people they were caring for well and spoke about them warmly, one staff member said, “The residents are really great, they are the highlight of my day” People told us they felt well cared for and that their views were listened to. One person said, “They are always asking me what I need and if they can do anything to help me, I feel cherished here.” Staff treated people respectfully and maintained their dignity and privacy.

Staff provided care that was personalised to the needs of people. Care records contained details of people’s background, their wishes and preferences and we saw how staff used this information to ensure care was personalised. Activities were tailored to people’s interests and people told us they had lots of choice in how they spent their time. Staff were able to spend time with people and the atmosphere in the home was calm and happy, with saw lots of laughter and positive interactions between staff and people living at Villa Adastra.

People and staff spoke highly of the registered manager and said that they were approachable and proactive in seeking feedback about the service. People knew how to complain and had confidence that any issues would be addressed. The registered manager provided visible leadership and the values of the service were well embedded within the staff team. There were robust quality assurance systems in place that were used to drive service improvements and the staff team were well motivated and open to learning and support from outside the home. There was a calm and peaceful atmosphere in the home.

The staff also told us they felt valued and supported by the management and had their training needs met. The staff told us they felt confident that the quality of care delivered in Villa Adastra was of a very high standard. We found care plans, staff records and other records relevant to the management of the home were accurate, reviewed regularly and fit for purpose.

The home had systems in place to assess and continually review the service that it provides and had made improvements where needed. We found that people were involved in the planning of their care, and in any changes to the service that may have affected them.

We also looked at other records to help us understand the needs and views of the people who used the service. These included a patient satisfaction survey, minutes of staff and residents meetings, staff personnel files, and the homes incident and complaints log.

Residents were keen to tell us that they thought there were enough staff engaged to look after them and staff generally responded quickly to call bells and requests for assistance. Everyone that we spoke to said that they found staff kind and caring and very respectful. Residents told us that they felt safe living at the home and would speak to any member of staff if they had any concerns or complaints. They said that if they had reason to speak to someone they had confidence that their concerns would be addressed immediately. There were mechanisms in place to enable residents to feedback their views on the service.

Several members of staff told us 'this is the resident's home, we come in every day to deliver care but they live here'. Regular activities were provided for groups and individuals and residents told us they were able to choose how they wanted to spend their day. We observed a large group of residents participating enthusiastically in a Christmas quiz.