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Inspection Summary


Overall summary & rating

Good

Updated 16 February 2019

This inspection took place on 23 and 29 January. Both days were unannounced.

Warde Aldam is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Warde Aldam can accommodate up to 60 people who require accommodation and nursing or personal care. The home consists of one adapted building across two floors. At the time of our inspection there were 57 people living in the home.

Our last inspection of Warde Aldam took place on 10 October 2017. We rated the service requires improvement. We found there was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; Need for consent. This was because conditions on Deprivation of Liberty Safeguards (DoLS) authorisations had not always been recorded and evidenced throughout the care plan. We also found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; Good Governance. This was because effective audits were not always in place in relation to peoples care plans.

Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the service to at least good. At this inspection we found sufficient improvements had been made to meet the requirements of both Regulation 11 and 17 and the service had improved to good.

There was a registered manager employed at the home. A registered manager is a person who has registered with the CQC 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.

Staff had completed MCA training and during the inspection we saw staff asking for consent when providing care to people. People's care records evidenced their mental capacity had been considered and assessed, where appropriate. People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible. The policies and systems in the service support this practice.

At the last inspection we found audits did not always pick up shortfalls in the running of the home. At this inspection we found significant improvements to the governance of the home. The registered manager completed regular audits of the service, to make sure action was taken and lessons learned when things went wrong. Effective systems were in place to support the continuous improvement of the service.

People and relatives told us they believed they were safe. There were enough staff available to meet people's needs in a timely way and to keep people safe. Staff had been trained in how to safeguard vulnerable adults and they had a good understanding of their responsibility to protect people from harm.

People received their medicines as prescribed from staff who had been trained in medicines management.

People told us the staff were kind and caring and respectful of their needs. During this inspection we observed staff treat people with kindness, dignity and respect.

Staff received a range of training which the provider considered to be mandatory. Staff told us they were happy with the training they received and felt it supported them in their roles. Staff were supported by the management team through supervisions and appraisals.

The service worked closely with community health professionals to support people with their health needs. People's care records evidenced they received medical attention when they needed it, to promote their health.

People were supported to eat a varied diet that met their nutritional requirements. The service had protected mealtimes where all staff supported the provision

Inspection areas

Safe

Good

Updated 16 February 2019

The service was safe.

There were sufficient numbers of staff deployed to meet people's needs.

People received their prescribed medicines, from trained and competent staff.

Staff understood how to keep people safe. Any incidents and accidents were recorded and analysed. This helped the service to learn from them and prevent similar incidents occurring.

Effective

Good

Updated 16 February 2019

The service was effective.

Staff were provided with an induction, relevant training and regular supervision and an annual appraisal to give them the right skills and knowledge to support people.

People were supported to maintain a varied diet. The service worked closely with a wide range of health and social care professionals to support people to maintain their health.

The service was working within the principles of the Mental Capacity Act 2005. Staff had received training in this area and understood what it meant in practice.

Caring

Good

Updated 16 February 2019

The service was caring.

People and their relatives were overwhelmingly positive in the comments they made about staff.

People were treated as individuals. Their choices and preferences were respected. Staff spoke with knowledge about people's needs and their likes and dislikes.

During this inspection we observed staff respect people's privacy and dignity.

Responsive

Good

Updated 16 February 2019

The service was responsive.

People's care records accurately reflected their needs and were regularly reviewed and updated. This supported staff to provide person-centred

care.

The service had an effective complaints policy in place.

A range of individual and group activities were available in the home.

Well-led

Good

Updated 16 February 2019

The service was well-led.

Staff felt supported by the registered manager and they told us they enjoyed their jobs. There was a positive and welcoming culture within the home.

The provider had effective quality assurance systems in place to identify any issues and rectify them.

People and their relatives were asked for their feedback about the service. The registered manager used this feedback to help drive improvements to the service.