Background to this inspection
Updated
25 July 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
The inspection took place on 2 and 5 May 2017 and was unannounced. An inspector and inspection manager undertook this inspection.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We checked the information that we held about the service and the service provider. This included previous inspection reports and statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.
We observed care and spoke with people and staff. We spent time looking at records including six care records, two staff files, medication administration record (MAR) sheets, staff rotas, the staff training plan, complaints and other records relating to the management of the service.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
On the day of our inspection, we met with four people living at the service and spoke with five relatives and three friends of people living at Aldwick House. We chatted with people and observed them as they engaged with their day-to-day tasks and activities. We spoke with the manager, the area manager, the quality manager, the clinical lead, two care staff, the chef and the activities co-ordinator.
The service was last inspected on 25 and 26 February 2016 and was rated as 'Requires Improvement' overall.
Updated
25 July 2017
The inspection took place on 2 and 5 May and was unannounced.
The last inspection took place on 25 and 26 February 2016. As a result of this inspection, we found the provider in breach of two regulations, one relating to safe care and treatment and the other associated with the need for consent. We asked the provider to submit an action plan on how they would address these breaches. An action plan was submitted by the provider which identified the steps that would be taken. At this inspection, we found the provider and manager had taken appropriate action and these regulations had been met. As a result, the overall rating for this service has improved from 'Requires Improvement’ to ‘Good’.
Aldwick House is registered to provided accommodation and nursing care for up to 32 people with a range of healthcare needs, including a diagnosis of dementia. At the time of our inspection, 30 people were living at the home. When capacity was available, the home also offered short breaks or respite for people, providing care on a short-term basis. Aldwick House is a large detached, older style property, with accessible gardens, close to the town of Bognor Regis and the coast. Communal areas include a large lounge and dining area with a conservatory. All rooms are of single occupancy, apart from one, where two people have shared a room for a number of years. There were plans to replace the lift in the near future.
The manager came into post at the home in January 2017 and was in the process of becoming registered. 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.
Supervision meetings for some staff had lapsed since the last registered manager left employment and the new manager had started. The manager was aware of this and had identified it as an area for improvement. People and relatives liked the meals on offer, however, arrangements within the home made it difficult for some people to eat independently. Staff were not always positive towards making the mealtime a sociable experience for people.
Staff had completed a range of training and attended staff meetings to ensure they had the skills and guidance necessary to support people effectively. Staff were encouraged to study for qualifications, such as diplomas in health and social care, and new staff completed the Care Certificate, a universally recognised qualification. Consent to care and treatment was sought in line with legislation. People received support from healthcare professionals and had access to healthcare services.
People and their relatives felt Aldwick House was a safe place to live. Risks to people had been identified and were assessed appropriately. Guidance was in place for staff on how to manage risks. Staff had been trained to recognise the signs of potential abuse and knew what action to take. Staffing levels were sufficient to meet people’s needs and there were plans to increase staffing levels. Safe recruitment systems were in place. Medicines were managed safely.
Positive, warm and friendly relationships had been developed between people and staff. We observed positive interactions between staff and people. People and their relatives were encouraged to express their views in relation to their care. People were treated with dignity and respect. At the end of their lives people were supported to have a comfortable, dignified death.
A range of activities was provided for people from an activities co-ordinator employed by the home and an external entertainer who visited each weekday. People were also provided with individual support where they chose not to be involved in group activities. The provider had put in place a strategy to improve the way people living with dementia were supported and cared for. Care plans provided detailed information about people’s care needs and guidance to staff on how they wished to be supported. People and relatives felt confident that any concerns or complaints they had would be addressed appropriately.
People and their relatives were involved in developing the service and regular meetings took place. Questionnaires had been sent out to obtain people’s feedback. The home was well managed and good leadership was evident. Staff spoke highly of the new manager, who felt that they now had a sound staff team in place. Relatives were complimentary about the care their family members received. A range of systems was in place to measure and monitor the quality of care delivered. Where actions were identified, steps were taken to make improvements.