Archived: Alderwood L.L.A. Limited - Cransley

Updated 28 October 2024

Alderwood Cransley is a residential care home providing personal care to up to 6 people. The service provides support to autistic people with learning disabilities. At the time of our inspection there were 4 people using the service who all had transition plans to move.The provider had notified CQC and partner agencies of the planned closure of the service. Two people being supported had already moved on from the service, one person was transitioning to their own service provided by Achieve Together and another person was being supported by the provider to move to another home. At the time of the inspection the provider was engaged with the local authority and funding authorities in a large scale enquiry. Feedback from partner agencies was that the provider had engaged positively in this process with the aim of supporting people living at Cransley to successfully move to alternative places.

The service is a large building within a residential area but is inconspicuous due to being within other large domestic properties.

We assessed 8 quality statements for this assessment. The scores for these areas have been combined with scores based on the rating from the last inspection, which was Inadequate in the Key areas of Safe, Responsible, and Well-Led, and Requires Improvement in the Key areas of Effective and Caring (published 7th May 2024). We had identified breaches in relation to safe care and treatment, safeguarding, person centred care, good governance, staffing and dignity. We issued 4 warning notices and 2 actions which we expected the provider to comply with. We carried out unannounced site visits on the 11th, 12th and 14th November 2024, and finished the assessment on 8th January 2025. We reviewed information we had received about the service since the last inspection. We spoke to people who live at Cransley, and members of staff who work there. We sought feedback from the local authority, and commissioners. A Care Quality Commission (CQC) specialist medicines inspector, and specialist advisor supported the assessment. We spent time in the care home speaking to people and observing people who were non-verbal. We visited during the day and evening. We saw that some improvements had been made since the last inspection but found that the previous warning notices had not been complied with for 3 regulations in the areas of Safe Care and Treatment, Safeguarding, and Good Governance. Sufficient improvements were not found at this assessment and the provider remained in breach of these regulations.

Updated 28 October 2024

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' (RSRCRC) is the guidance CQC follows to make assessments and judgements about services and providers must have regard to it.

We observed staff interactions with people were kind and efforts had been made to improve how people were talked about in care records. Mental capacity assessments and risk assessments were in place, but it was not clear if staff always supported people in the least restrictive way possible. People had not been supported to live safely and comfortably at the service, free from abuse and harm. This situation had improved recently due to changes which had taken place, but we are not assured this had happened in a timely manner, and following the providers own effective systems and processes. Staff did not fully understand restrictive practices, or when safeguarding needed to be referred to appropriate bodies. People were not always supported to have maximum autonomy, choice and control of their lives. New systems were in place to try and support this practice going forward.

People were supported to access health and social care support however this was not always carried out in a timely manner. People’s day to day health needs were not always managed appropriately. Gaps in staff training and recruitment had been identified. Improvements had been made in medicines optimisation.

Peoples care records were not always consistent with the information in them. People were not consistently receiving individualised care and support. People were not supported to develop skills and independence at an individual level. Improvements were being made to improve communication with people so staff could better understand people's individual needs.