We carried out a review of the data available to us about Alliston 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 Alliston House, you can give feedback on this service.
We found the following examples of good practice.
There were procedures to reduce risk from any visitors to the home spreading infection at the entrance to the premises. The provider screened all visitors to the home for symptoms of acute respiratory infection before they could enter the home. Essential care givers (ECG) and other visitors were supported, to follow the government's guidance on visiting, hand washing, sanitising, wearing personal protective equipment (PPE), temperature checks, and social distancing whilst on the premises.
There was an enhanced COVID-19 testing program in place for people using the service and staff in line with the government guidelines. When people or staff showed symptoms, they were required to self-isolate.
There had been no new admission to the home during the outbreak.
The provider carried out relevant checks prior to any new admission to the home. The checks included; Covid-19 RT PCR test report showing a negative result, the person was not returning from an environment infected with Covid-19, and they were fully vaccinated.
We observed staff wearing appropriate PPE, socially distancing, and the home was clean throughout. The registered manager told us, they were always well stocked with PPE, which included hand sanitiser, disposable aprons, mask, gloves, visors, and face shield. Staff were trained on how and when to use PPE and their disposal, as appropriate. There were dedicated places on each floor for staff donning and doffing of PPE.
There had always been enough staff to meet people's needs throughout the pandemic. All staff had received training on COVID-19, infection control, the use of PPE, and they had been fully vaccinated.
The provider had a COVID-19 specific policy and procedures, and a contingency plan in place which they had followed throughout the COVID-19 pandemic. The registered manager told us there were no restrictions on visiting at the home in accordance with the current guidance.
We found the following examples of good practice.
¿ The premises were clean and well maintained. Additional cleaning schedules had been introduced since the beginning of the coronavirus pandemic in order to minimise the risk of the spread of infection. Hand sanitiser was readily available throughout the premises. Visitors had their temperature taken and recorded, personal protective equipment (PPE) was available at the entrance and people were supported to follow the Governments guidance on wearing PPE and social distancing.
¿ The provider had appropriate arrangements to test people and staff for COVID-19 and was following government guidance on testing. This ensured that people and staff were tested for COVID-19 in a consistent way in line with national guidance.
¿ The provider ensured that staff received appropriate training and support to help prevent the spread of infection. All staff had received training on infection control and the use of PPE. Staff were assigned to work at the one location to help minimise the risk of cross infection. Staff wellbeing was supported if they became unwell and when they returned to work.
¿ The provider ensured that people using the service could maintain links with family members and friends. Family members and friends could stay in touch with people with window visits, and phone and video messaging. The provider understood the communication needs of people.
¿ The registered manager sought support and advice from external agencies including the Clinical Commissioning Group, the local authority and Public Health England and was open to all advice and guidance offered to help keep people safe.
Alliston Road is a residential care home providing personal care to 36 older people and people living with dementia. The care home accommodates people over three floors in one adapted building with a lift. The service can support up to 43 people.
People’s experience of using this service and what we found
People were supported by kind and caring staff who treated people as individuals and with dignity and respect. The provider had robust recruitment systems to ensure staff were safely recruited. Staff spoke knowledgeably about the systems in place to safeguard people from abuse. People were supported by staff who were inducted, trained and supervised.
People told us they felt safe. Risks to them were identified and managed. Where required people were safely supported with their medicines needs. Infection control measures were in place to prevent cross infection. The support required by people with health and nutritional needs was identified and provided.
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’s privacy and independence were promoted. Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.
People had person centred support plans in place. People and their relatives were actively involved in their care and contributed to the development of care plans and reviews. People’s communication needs were identified, and their end of life care wishes were explored and recorded.
People and relatives told us activities offered were limited. We have made a recommendation in relation to activities.
The provider had effective quality assurance systems to monitor the quality and safety of the care provided. People were asked for their views and their feedback used to improve the service and make any necessary changes.
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 21 June 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.
There was 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.
The experiences of people who lived at the service were positive. People and their relatives told us they felt the service was safe, staff were kind and the care they received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults.
People’s needs were assessed and their preferences identified as much as possible across all aspects of their care. Risks were identified and plans were in place to monitor and reduce risks. People had access to relevant health professionals when they needed them. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed.
Medicines were stored and administered safely. However topical medicines were not always recorded correctly and stored appropriately. We have made a recommendation about the management of topical medicines.
Staff undertook training and received regular supervision to help support them to provide effective care. Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests. We saw people were able to choose what they ate and drank.
People’s needs were met in a personalised manner. We found that care plans were in place which included information about how to meet a person’s individual and assessed needs. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.
The service had a complaints procedure in place and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant.
Staff told us the service had an open and inclusive atmosphere and the registered manager and deputy manager were approachable and open. People, relatives and staff felt the registered manager had improved the quality of the service since they had started. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and staff and relative meetings.
We inspected Alliston Road on 15 & 16 September 2015. This was an unannounced inspection. At the last inspection in December 2014 we found breaches of the legal requirements. This was because risk assessments and care plans were not always up to date and information was missing. There were poor arrangements in place for the management of medicines. Meaningful engagement and interaction and activities were not available to people. At this inspection we found improvements had been made and that they now met the previous legal beaches.
Alliston Road provides accommodation for up to 43 older people who have dementia care needs. There were 35 people living at the home when we visited. There was a registered manager at the service at the time of our inspection. 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.
The experiences of people who lived at the home were positive. People told us they felt safe living at the home, staff were kind and the care they received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults.
People’s needs were assessed and their preferences identified as much as possible across all aspects of their care. Risks were identified and there were plans in place to monitor and reduce risks. People had access to relevant health professionals when they needed them. Medicines were stored and administered safely.
Staff undertook training and received one to one supervision to help support them to provide effective care. The registered manager and staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests. People told us they liked the food provided and we saw people were able to choose what they ate and drank.
People’s needs were assessed and met in a personalised manner. We found that care plans were in place which included information about how to meet a person’s individual and assessed needs. The service had a complaints procedure in place and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant.
The service had a clear management structure in place with clear lines of accountability. Staff told us the service had an open and inclusive atmosphere and senior staff were approachable and accessible. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and staff and resident meetings.
We inspected Alliston Road on 25 November and 3 December 2014. This was an unannounced inspection. At the last inspection in August 2013 the service was found to be meeting the regulations we looked at.
Alliston Road provides accommodation for up to 43 older people who have dementia care needs. There were 33 people living at the home when we visited. There was not a registered manager in post on the day of our inspection. The last registered manager for the service left in July 2014. The provider had an acting manager in post while they were recruiting to the position. The acting manager started in September 2014. 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.
People were not always kept safe at the home. There were poor arrangements for the management of medicines that put people at risk of harm. Risk assessments were in place however those we looked at had not been signed and no review date given. It was not always clear when a review had been completed. It was also not clear if information from previous risk assessments had been included onto the new templates. The lack of ongoing assessment of risks to people did not help to protect them against the risk of receiving inappropriate or unsafe care and treatment.
The service had a safeguarding procedure in place and staff were aware of their responsibilities with regard to safeguarding adults. There were enough staff at the service to help people to be safe.
Each person had a care plan which set out their individual and assessed needs. However, some people were not protected against the risks of unsafe or inappropriate care and treatment by means of the maintenance of accurate monitoring records in relation to the care.
Staff told us they undertook regular training however the service could not provide up to date evidence that staff had done the training they said they had done. Staff received supervision which supported them to meet people’s needs.
Most of the people told us there were not enough activities. During the course of our inspection over two days we did not see evidence any activities taking place. We saw people left alone in their bedrooms not engaging in any stimulating interaction.
Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).
People told us they felt cared for. People could make choices about how they wanted to be supported and staff listened to what they had to say.
People were treated with respect and the staff understood how to provide care in a dignified manner and respected people’s right to privacy. The staff knew the care and support needs of people well and took an interest in people and their families to provide individual personal care.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
People told us they received care which met their needs. One person told us the care was "good". A relative we spoke with told us "I'm happy with the care." People's files contained information about their 'life history' which allowed staff to know details about their lives. This enabled staff to better cater to their needs. One staff member told us this helps her "know the person better."
People we spoke with told us they felt safe with the care they received. We found there were enough qualified, skilled and experienced staff to meet people’s needs. We reviewed the staff rota. We saw during the day there were enough staff to meet people's needs.
The provider had a system in place to identify, assess and manage risks.
We found risk assessments had been undertaken to identify risks to people and plans had been put in place to ensure people's safety and welfare. We found people felt safe with the care they received. Staff were knowledgeable about the different forms of abuse and how to recognise the signs of abuse.
We found staff safely administered medicines and kept them safely locked away. We also found there were appropriate procedures in place to record medicines.
People told us they felt the premises were clean and hygienic. We found the provider was taking appropriate steps to maintain the cleanliness and hygiene of the premises including providing hand wash and hand sanitiser in all toilets and bathrooms.
We found staff were supported in their roles and responsibilities and from time to time were enabled to pursue further qualifications.
The views of people and their relatives were regular sought about the quality of the service they received. People's records were kept safely and were easily located when we requested them.