Archived: Adlington House - Portishead

Adlington House is a domiciliary care agency that provides personal care to people living in their own homes. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection there were 12 people receiving support with their personal care.

People’s experience of using this service and what we found

People received their medicines when required and from staff who had received medicines training. Staff knew people well and people received support from regular carer staff. People felt safe and staff were familiar with the different types of abuse and who to raise concerns with should they suspect abuse had occurred. Care plans contained important information relating to people’s risks and staff had clear guidance on how to support people with those risks.

People were happy with the support they received from the care staff and felt able to discuss anything with the management. Staff had received Covid-19 and infection control training and people confirmed staff wore their personal protective equipment (PPE) as required. Audits were in place to check medicines records and incidents and accidents and the provider also monitored the service and made improvements where required. People and staff views were sought, and various positive compliments had been received about the care and support people received.

Rating at last inspection:

The last rating for this service was requires improvement (published 8 November 2019).

Why we inspected

We carried out a comprehensive inspection of this service on 26 September 2019. Three breaches of legal requirements were found in safe and well led. The provider completed an action plan after the last inspection to show what they would do to improve the safe administration of medicines, staffing numbers and quality assurance checks.

We undertook this focused announced inspection on 7 and 11 May 2021. This was to check they had followed their action plan and to confirm they had met legal requirements in safe and well led. This report only covers our findings in relation to the Key Questions Safe, which contain those requirements and Well-led.

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 Adlington House – Portishead 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.

People’s experience of using this service and what we found

Medicines were not always being administered when required and records were not always up to date and accurate. People and relatives felt there was not always enough staff or a stable staff team, given the amount of staff that had left and agency staff being used. Staff had checks undertaken prior to starting work within the service. Staff were familiar with what to do should they suspect abuse and the different types.

Staff felt able to raise any concerns in between their supervision meetings. However not all staff were receiving supervisions in line with the provider’s policy. Staff also required an annual appraisal.

People received support with their nutrition and hydration needs, however one person’s risk assessment required updating in line with the risk around choking. No referral had been made to assess this risk and if any recommendations were required to support the person with their nutrition following these concerns.

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.

People and relatives felt staff were courteous, kind and caring, however some staff were unfamiliar with people’s needs. Staff were not always able to demonstrate a clear understanding of equality and diversity.

Care plans were personalised and contained important information relating to likes and dislikes.

People felt able to raise a complaint should they need to. Incidents and accidents were recorded, and an overview held so that any trends and themes could be identified. People had end of life wishes recorded within the care plan.

Staff were happy and felt well supported. People felt the manager was approachable and friendly. People were supported to access medical appointments when required. People could attend various activities and be part of daily routines within the service.

Rating at last inspection: Good (published March 2017).

Why we inspected: This was a planned inspection based on the previous rating. At this inspection we found the overall rating had changed from Good to Requires Improvement.

Follow up: We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We requested an action plan as part of our inspection findings. We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.

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

Adlington House provides onsite support and care to people in their own homes. They are a domiciliary care service and provide assistance with bathing, dressing, meal preparation and medicines.

At the time of the inspection, the service was providing personal care to nine people. There was a registered manager at the service. 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 and associated Regulations about how the service is run.

The service had suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the service had a whistleblowing policy in place. Staff felt confident that they could raise any matters of concern with the registered manager, or the local authority safeguarding team.

The service provided sufficient numbers of staff to meet people's needs and provide a flexible service. The registered manager carried out risk assessments when they visited people for the first time. Other assessments identified people's specific health and care needs, their mental health needs, medicines management, and any equipment needed.

Care was planned and agreed between the service and the individual person concerned. People were supported by their family members to discuss their care needs, if this was their choice to do so.

There were effective recruitment practices in place. Applicants were assessed as suitable for their job roles. Refresher training was provided at regular intervals. All staff received induction training at start of their employment.

People were supported with meal planning, preparation, eating, and drinking if required. Staff supported people, by contacting the office to alert the registered manager to any identified health needs so that their doctor or nurse could be informed.

People said that they knew they could contact the registered manager at any time, and they felt confident about raising any concerns or other issues. The registered manager carried out spot checks to assess care staff's work and procedures, with people's prior agreement. This enabled people to get to know the registered manager.

The service had processes in place to monitor the delivery of the service. As well as talking to the registered manager at spot checks, people could phone the office at any time. People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues. People spoke positively about the way the service was run.

The management team and staff understood their respective roles and responsibilities. Staff told us that the registered manager was very approachable and understanding.