We carried out a review of the data available to us about Adams House 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 Adams House, you can give feedback on this service.
Adams House is a residential care home providing personal care to 22 people living with a learning disability or mental health condition at the time of the inspection. The service can support up to 24 people.
Adams House has several adapted bungalows and individual apartments within a large house situated on a campus style service in Sutton in Ashfield. People living in the bungalows have their own room and access to a range of shared facilities. They can also use a range of facilities in the grounds of the service.
The service takes note of the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service is located on a campus style community and as such would not fit with current best practice guidance which suggests small local services, integrated with the community. However, the size of the service having a negative impact on people was mitigated by the use of individual buildings. Staff supporting people did not wear a uniform or any identifying clothing that suggested they were care staff when coming and going with people, and people were supported to have access to local community facilities and services.
People’s experience of using this service and what we found
People received person-centred support and staff knew people very well. Plans were in place, that detailed how people wanted to be supported and we saw staff followed this guidance.
People were supported to build and maintain important personal relationships that mattered to them, with peers and relatives.
People were supported to be independent, their rights were respected and access to advocacy was available if required. Support was provided in a way that put the people and their preferences first. Information was readily available for people in the correct format for them, including easy read.
The environment was clean, and people chose colours and furniture for their own rooms and communal areas. During our inspection staff and relatives were helping re-decorate as several people were away on holiday with other staff members.
Medicines were managed well, safely administered and recorded accurately.
There were enough staff to support people and staff were always visible. Staff received support and a variety of appropriate training to meet people’s needs.
Individualised risk assessments were in place. Staff were confident they would raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.
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 supported this practice. People were well supported to make informed choices and given the opportunity to make decisions about their care and support.
Appropriate healthcare professionals were included in people’s care and support as and when this was needed. Staff supported people to maintain a healthy diet and, when required, follow a specialist diet.
People were supported to engage in activities they enjoyed, and we saw the service promoted people accessing local community facilities and supporting them to go on trips and holidays.
There were systems in place for communicating with staff, people and their relatives to ensure they were fully informed this was via team meetings, phone calls and emails. People had good links to the local community through regular access to local services.
Audits and monitoring systems were used effectively to manage the service and to make improvements as and when required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 9 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
Adams House provides accommodation and personal care for up to 24 people living with learning disabilities and an autistic spectrum disorder. At the time of our inspection there were 23 people living at the service. Accommodation included four bungalows and eight individual apartments and one shared apartment within the same grounds.
Adams House is required to have 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. At the time of the inspection a registered manager was in place.
Staff were aware of the safeguarding procedures and had received appropriate training. Safeguarding incidents had been reported and appropriate action taken to reduce further risks. People received their medicines as prescribed; some minor concerns were identified with the management of medicines but this did not impact on people’s safety. Safe recruitment practices meant as far as possible only people suitable to work for the service were employed.
Accidents and incidents were recorded and appropriate action was taken to reduce further risks. Improvements to the analysis and review procedure to help identify any themes, patterns or concerns were being made. Risks plans were in place for people’s needs and were regularly monitored and reviewed. The safety of the environment and equipment was checked regularly.
There were sufficient staff to meet people’s needs. People’s dependency needs were reviewed on a regular basis for changes.
Staff were appropriately supported, this consisted of formal and informal meetings to discuss and review their learning and development needs. Staff additionally received an induction and ongoing training.
People’s rights were protected under the Mental Capacity Act 2005 although some inconsistencies were found with the completion of capacity assessments.
People received sufficient to eat and drink and their dietary needs and preferences were met and choices promoted.
People’s healthcare needs had been assessed and were regularly monitored. The staff worked with external health professionals in meeting people’s healthcare needs.
People and relatives reported that staff had a good, caring approach. They described staff as caring, compassionate and knowledgeable about their needs. People’s preferences, routines and what was important to them had been assessed and recorded. Support was provided to enable people to pursue their interests and hobbies. Some inconsistencies were found with how staff communicated with people.
The provider supported people to be actively involved in the development and review of the care and support they received. This included regular discussions with people and formal meetings. Person-centred planning records showed gaps in how people were supported to achieve their future goals and aspirations.
People told us they knew how to make a complaint and information was available for people with this information. Confidentiality was maintained and there were no restrictions on visitors.
The provider had checks in place that monitored the quality and safety of the service. People and their relatives and representatives, received opportunities to give feedback about their experience of the service. The provider was aware of their regulatory responsibilities.
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, and to provide a rating for the service under the Care Act 2014.
Our inspection was unannounced which meant the provider and staff did not know we were coming.
Adams House provides accommodation and care for up to 22 young adults with needs relating to learning disabilities. Accommodation is provided in four level accessed bungalows and six individual apartments, four of which are accessible by stairs. 19 people were accommodated when we visited. There was also a ground floor skills centre for people to use for daytime activities.
There was a registered manager who was on the premises throughout our inspection visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.
People who lived in the home told us they felt safe and we saw there were systems and processes in place to protect people from the risk of harm.
Staff received a wide range of appropriate training and were knowledgeable about the needs of people living in the home. They provided effective care and support that met people’s individual needs.
During our visit we found a caring atmosphere and people told us that staff were kind to them. People were able to pursue a wide range of interests and hobbies with appropriate support from staff.
Management systems were well established to monitor the quality of the service.
The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS is a code of practice to supplement the main MCA 2005 code of practice. We found staff were knowledgeable about how to apply both of these and current applications for DoLS were being assessed.
We reviewed a report about the action taken and we visited the service again to ensure sufficient staff were always available.
We observed how many staff gave support to people within two of the bungalows, we examined the staffing rotas and recruitment files and spoke with some staff.
Overall, we found improvements had been made and there were enough qualified, skilled and experienced staff to meet people's needs.
Staff were aware of people's individual preferences. People were supported individually by staff when they went out into the community and enjoyed a range of individually planned activities.
There were clear plans for staff to follow about how to support people safely and promote their independence.
The people we spoke with confirmed they felt safe and we found staff were fully aware of the procedure to follow should there be any suspicion of abuse of any kind.
We observed some of the staff working well with people individually, but we found there were not always enough qualified, skilled and experienced staff to meet people's needs at all times.
We found clear information was available about how to make a complaint and previous complaints had been taken seriously and well managed.
We saw people had been supported to personalise their bedrooms. Rooms reflected the person's favourite colours and were furnished to the person's individual needs with their personal belongings.
One person said, 'It's alright here. I go out with staff and help them in the kitchen to cook meals.'
We spoke with two people who said they were happy in their bungalow and felt safe.
Two people living there told us that there were always staff around to help them. One person told us he was independent with his personal care, but knew staff were there to support him when needed.
People told us they were well cared for and felt safe. A person said, 'It's nice.' They also told us they got on with everyone living at the home and went swimming, out for coffee and to the local disco. Another person told us they went out regularly and worked as a volunteer. They also told us that everything about the service was good.
A person told us that they self-medicated. People told us they liked their rooms. A person told us there were always enough staff, however, another person said there wasn't always enough staff and it had stopped them from being able to do some activities. People told us staff were well trained and good at their jobs.