We carried out a review of the data available to us about Adalah Residential Rest Home Limited 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 Adalah Residential Rest Home Limited, you can give feedback on this service.
Adalah Residential Rest Home Limited is a care home providing personal care without nursing for 28 people some of whom maybe living with dementia. The service can support up to 30 people.
People’s experience of using this service and what we found
Systems and processes were in place to manage risks. People were supported with their medicines in a safe way. Staff had received appropriate recruitment checks on their suitability to work at the service and there were enough staff on duty to meet people's needs. Staff had received safeguarding training and knew what action they should take if they suspected or witnessed abuse.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
There was a good atmosphere in the service and people and relatives were satisfied with the quality of care and support they received. Staff told us they felt supported by the management and the registered manager was approachable.
Systems were in place to monitor and improve the quality of the service. Audits of the premises helped ensure the premises and people were kept safe.
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We carried out an unannounced comprehensive inspection of this service on 7 October 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Adalah Residential Rest Home Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
¿ The service was carrying out regular testing of staff and people as per government guidelines.
¿ The service had ensured people were able to access communal areas safely. Tables and chairs had been moved apart to allow for social distancing.
¿ All staff had been trained in current Infection Prevention and Control (IPC) guidance and in the use of PPE. The service had designated areas for staff to put on and remove PPE safely. PPE was disposed of safely by the service. We observed staff were following current guidance and practice throughout our visit.
¿ Regular cleaning was in place at the service. Staff had robust cleaning schedules which included deep cleaning of all areas and extra cleaning of high use areas and touchpoints.
¿ Audits to make sure staff and the environment complied with current guidance and practice took place regularly. Any concerns identified were acted on without delay.
¿ The service was closed to new admission at the time of our visit. The registered manager confirmed they were following government guidance and all admissions were isolated in their rooms for 14 days.
¿ The service was working closely with healthcare providers, the local authority and Public Health England to ensure they were following current guidance and had a robust infection control policy in place.
Adalah is a residential care home providing personal care without nursing for up to 30 people some of whom maybe living with dementia. At the time of inspection 28 people were using the service. The service is set over three floors in a residential area.
People’s experience of using this service and what we found
One person said, “It is comfortable here, people are friendly I am happy here.” A relative told us, “I am very happy with the home.”
We have made a recommendation about quality assurance audits.
Medication audits needed to improve to ensure the registered manager had good oversight of medication practices at the service to ensure people received their medication safely and that medication was reviewed promptly when required.
Systems for governance and oversight were not sufficiently robust to address the issues highlighted at inspection.
Care and treatment were planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed.
People were cared for and supported by staff who had received the appropriate training.
The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. 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.
People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for the needs of people.
Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff worked to promote people’s independence through encouraging and supporting people to make informed choices.
People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner. People were supported at the end of their life.
Rating at last inspection
The last rating for this service was Good. (last report published 7 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement: We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to safe care and treatment: Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up: We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At the last inspection, the service was rated Good. At this inspection we found the service remained Good in most areas apart from Well Led as the service had not met the condition for having a registered manager at the time of our inspection.
The service was safe. The service’s recruitment process ensured that appropriate checks were carried out before staff commenced employment. There were sufficient staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health. The service needed to improve management and record keeping of administered medication.
The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services was made when required.
The service was caring. Staff cared for people in a empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.
The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints received in a timely manner.
The service was not well-led. This was due to the service not meeting the Registered manager’s condition as set out in the Health and Social Care Act 2008 as part of our regulatory function. However staff, people and their relatives spoke very highly of the new manager and how they informed to be very supportive and worked hard to provide an exceptional service since coming into the service. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis. The new manager informed that current systems and processes where being updated and improved.
The Inspection took place on the 27 and 28 May 2015.
Adalah Residential Rest Home provides accommodation and personal care without nursing for up to 30 persons who may be living with dementia. At the time of our inspection 24 people were living at the service.
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.
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.
People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The manager was up-to-date with recent changes to the law regarding DoLS and knew how to make a referral if required.
People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were met. The service worked well with other professionals to ensure that people's health needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, district nurse and mental health professionals.
Staff were attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.
People were provided with the opportunity to participate in activities which interested them. These activities were diverse to meet people’s social needs. People knew how to make a complaint; complaints had been resolved efficiently and quickly.
The service had a number of ways of gathering people’s views including talking with people, staff, and relatives. The manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to make improvements.
We looked at whether people were protected from unsafe or unsuitable equipment. We found that the chair lifts, passenger lift and bathing facilities had been well maintained through regular inspections. Comments and complaints people made were responded to appropriately.
People we spoke to told us they were happy with the care and support provided. They really appreciated the activities worker commenting that, 'she does so much' and, "gets the old brain working again."
Two people who use the service and three out of five visitors did say that more external activities would be good and whilst there were activities in house, more entertainment would be appreciated.
People said that they felt safe living at Adalah and that they would be able to tell somebody if they had any worries or concerns. They told us that they trusted staff and found them helpful, obliging and caring.
People told us they were satisfied with the quality of the service provided to them at Adalah and that they would feel able to raise any concerns with the manager.