Alderwood Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

There was very much a community feel to the home. The registered manager had worked hard with the staff team to establish good relationships with relatives, professionals and specific community groups, and people benefitted from these. Leaders worked with people and their relatives to build a culture that focused on enabling people to enjoy their lives. Staff knew people well, and promoted independence, choice, and support in the least restrictive way.

Staff we spoke with told us they enjoyed working at the home, although not all felt confident to speak up. We provided feedback to the regional manager and the registered manager with this regard. People and their relatives were positive about their experiences of the registered manager and told us the management and staff team were extremely approachable. Good relationships had been established.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. There was good oversight and involvement from the provider during this inspection. Key members of senior management attended the home on the first day of the inspection, to support the registered manager.

The management team were visible and provided staff with instruction, advice and guidance. There was good engagement with residents and relatives by staff and managers. Recent survey results showed us actions were taken in response to suggestions or requests. For example, new flooring had been ordered for some bedrooms, following a request from a relative at a meeting.

The staff team were spoken about in a positive way, and the registered manager appreciated and valued their contribution. They were committed to delivering person centred care so that people and their relatives felt comfortable and were made to feel welcome; that contributed to making the home a good place to be.

People we spoke with felt they could speak up and that their voice would be heard. Whilst the majority of staff we spoke with told us they felt supported and listened to, not all staff did. We explored some negative intelligence sent into CQC following this inspection with the Regional Manager and gave feedback to the registered manager.

Staff were provided with lots of opportunities to voice their opinions and any concerns they might have. There were regular meetings, supervisions and audits of staff practice. Staff meetings and ‘flash’ meetings were also mechanisms for information sharing between staff undertaking different roles in the home; all these ensured important information was cascaded to others and enabled improvement. We were assured the registered manager would address this and take appropriate action to ensure staff felt fully comfortable in speaking up in the future.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. There was good use of supervisions, observations and checks on competency to identify poor practice; work was undertaken with staff to foster improvement. The provider was proactive in sharing lessons learnt within and across the services. This was apparent in staff meeting minutes we saw.

A close relative of the registered manager was also employed at the home. We established this was in line with company policy and alternative measures had been put into place so that they were directly managed by an alternative senior member of staff. The provider had a policy in place to ensure staff were treated fairly and had equal opportunities to learn and develop their roles within the organisation. There were fair recruitment processes in place, which helped to protect the rights of staff under the Equality Act.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had audits in place to ensure they maintained oversight of the service. A home action plan outlined any actions taken in response to audit findings and whether these had been met. In a recent medication audit it had been flagged that people needed an up-to-date picture loaded up to the electronic medication system. This was necessary to reduce the risk of potential errors when administering medication. This had been addressed and completed prior to this assessment, and a prompt added onto the action plan to retake people’s photos in 6 months time. Any actions identified through audits were addressed without delay. Similarly, a new suggestion box had been purchased and placed in the foyer after an audit identified one was missing.

Feedback provided verbally to the registered manager during the 2-day inspection was also acted upon quickly, demonstrating their responsiveness and commitment to continuous improvement. This was further supported from feedback we received from a health professional. They considered the leadership to be approachable and open to constructive feedback. Actions had been made when advised and improvements made in the areas reviewed. Another professional responded with, “I am fully satisfied with the safety and management at the care home. I believe Alderwood Care Home provides a high-quality service to its residents. It has been very positive and reassuring to co-work with the management team, particularly with the manager.”

The provider clearly understood and carried out their duty to collaborate and work in partnership so that services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The home was an active member of the ENRICH network, established to help connect care homes with researchers, enabling studies that improve the lives of residents and staff. This network has also encouraged and empowered care home staff, residents, and their families to take part in and benefit from research. Managers and staff had attended meetings and participated in outcomes of research on dementia and reoccurring urinary tract infections, held in another local care home. All staff had also attended Mouth Care Matters, a health initiative established to promote good oral health in care homes. Care staff had received oral hygiene training, understood the importance of this and had implemented oral health within care plans.

Feedback received from partners was extremely positive. We asked health professionals for any examples of people achieving good outcomes because of partnership working. One response we received was that many people and families had been given the opportunity to discuss and plan their wishes and preferences relating to palliative and end of life care.

The provider also worked in partnership with community groups and local businesses. The registered manager strived to strengthen community connections and promote social inclusion for the benefit of people living in the home. Links had been established with the local Royal Horticultural Society’s (RHS) garden at Bridgewater. Residents had attended a dementia day at RHS, and RHS had supported the home with donations of flowers. They were keen to receive feedback from people living in the home who had attended RHS events so they could improve future visit experiences for everyone living with dementia. The home chose to donate to a local charity that supported people who were homeless as this was advocated by their local minister; the monthly services held at the home were enjoyed by many.

Inter-generational relationships with students, both at school and university, were enjoyed. Younger children had attended the home to talk to people willing to share any World War 2 experiences, whilst people had assisted university students as part of their research for their studies. One student was part of a string quartet and had returned with the other musicians to play for people to say, ‘thank you’.

The initiatives the registered manager had developed with numerous partners demonstrated a strong commitment to community involvement and partnership working; people were supported to maintain meaningful connections and also encouraged to make new ones.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider could evidence a good culture of learning, where opportunities for continuous improvement were actively sought. Accidents or incidents were subject to an analysis to determine the cause of the incident and whether people’s needs had changed. This approach ensured the service learned from events and identified emerging risks.

The registered manager had a suite of tools at their disposal to assist with this as governance systems ensured that accidents and incidents were recorded. Lessons learnt were shared with staff via meetings and staff supervisions were also used as an opportunity to reflect on incidents that had occurred. Informed decisions were made to change practice where necessary to help improve the quality and safety of care.