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Alderwood L.L.A. Limited - Westfield Good


Inspection carried out on 4 November 2015

During a routine inspection

Alderwood LLA Ltd Westfield provides accommodation, personal care and support for two people with a learning disability and autistic spectrum disorder. It is situated in a residential part of Wellingborough. On the day of our inspection two people were receiving a bespoke service, tailored to their specific needs and requirements, which included some day care and overnight stays in the service.

The inspection took place on 4 November 2015.

The service had a registered manager. 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.

We found a really positive, caring and progressive atmosphere within the service. People were at the heart of the service and all aspects of care had been centred on them and their needs. There was lots of laughter and good humour, with kind and trusting relationships evident between staff and people. People were involved in the planning of their care and told us they felt included in discussions, being able to have their say at each step of the way. Staff were passionate about their work and driven by a desire to provide high quality care. They were flexible and adaptable, ensuring that people participated in their own care and achieved their full potential, helping them to lead a meaningful life, doing things that were important to them. The provider philosophy was that people should be able to access the best of everything in life and have ample opportunities to achieve their goals.

The service was led by a dedicated and passionate registered manager, who was well supported by a strong and positive management structure within the provider organisation. The culture within the service was open, optimistic and encouraging; staff were proud to work for the service and wanted it to be the best it could. Staff and the registered manager were extremely well motivated and committed to their work; they faced up to challenges and used these to improve things. They had strong values and a shared vision, and strived to give people positive care experiences and provide high quality care.

Staff attended regular meetings, which gave them an opportunity to share ideas, and exchange information about possible areas for improvements to the registered manager. Ideas for change were welcomed by the registered manager and provider, and used to drive improvements and make positive changes for people. Quality monitoring systems and processes were used robustly to make positive changes, drive future improvement and identify where action needed to be taken. All staff told us they wanted standards of care to remain high and so used the outcome of audit checks and questionnaires to enable them to provide excellent quality care.

People felt secure in the service and we observed they were calm and relaxed in the presence of staff. Staff had a positive approach towards keeping people safe and demonstrated a strong awareness of what constituted abuse. They understood the relevant safeguarding procedures to be followed in reporting potential abuse. Staff were committed to managing fluctuating risk factors for people and had a good understanding of how to support them when they became anxious or distressed. Potential risks to people had been identified, and detailed plans implemented to enable them to live as safely and independently as possible.

Robust recruitment checks took place in order to establish that staff were safe to work with people before they commenced employment. There were sufficient numbers of staff available to meet people’s care and support needs and to enable them to do the things they enjoyed. People received their medication as prescribed. Safe systems and processes were in place to protect people from the risks associated with medication.

Staff received regular training, based upon best practice in autism, which provided them with the knowledge and skills to meet people’s needs in a person centred manner. They were well supported by the registered manager and senior management team in respect of supervision and appraisal which enabled them to remain motivated and responsive to people’s individual needs.

Staff sought people’s consent before they provided care and support. Where people were unable to make certain decisions about their care, the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. Where people had restrictions placed upon them, staff ensured people’s rights to receive care that met their needs was protected, and that any care and treatment was provided in the least restrictive way.

People were supported to access suitable amounts of good quality, nutritious food. A variety of meal options were available for people, which included specific health and cultural dietary requirements. We found people were encouraged and supported to participate in meal preparation as part of developing their life skills. Referrals to health and social care professionals were made when appropriate to maintain people’s health and well-being. Staff worked closely with other professionals to ensure people’s needs were fully met.

People had been supported to develop life skills and gain independence, using individually created development programmes. The support for this was provided by a highly skilled staff group, who shared a strong person centred ethos and were dedicated to helping people lead a fulfilled and enriched live. People and their relatives expressed their delight at the progress they had made since coming to the service, which was often way beyond the level of achievement they had previously hoped for. Staff used innovative ways to support people to move forward, adapting when their needs changed. They had a strong understanding of people’s interests and hobbies and accessed a wide range of activities that were tailored to people’s individual needs. People were actively supported to integrate within the local community, using local facilities to avoid social isolation. To facilitate this, the service had developed links with local colleges, libraries and local employers offering work experience

Inspection carried out on 29 April 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected during our inspection at Alderwood Westfield. We used the information to answer the five questions we always ask.

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive to people's needs?

• Is the service well led?

This is a summary of what we found:

Is the service safe?

People living in the home told us that there were enough staff on duty to make sure people were cared for safely and our observations confirmed this. We found that the staffing ratio facilitated people to participate in activities of their choice, both within the home and the wider community.

We found evidence to suggest that people enjoyed a good quality of life. One person told us, “It’s ok being here, the staff are kind, I have my room how I like it and I get to go out lots.” Another person said, “They keep me safe.”

We found that people were protected from potential abuse because staff understood their role in safeguarding the people they supported. Staff ratios enabled them to manage people's support needs in a caring and considerate way.

Person centred care plans and individual risk assessments were updated regularly and contained comprehensive, specific detail to guide staff to deliver consistent care and ensure that people were protected from harm.

We found that there was a robust system in place to make sure that manager and staff learnt from events, including accidents and incidents, health and safety issues, complaints and concerns. This meant that the risk of harm to people was reduced and that the service was able to evidence its intention to provide proactive care which took account of future improvements.

Is the service effective?

People living in the home had their needs assessed and we observed that staff understood people’s individual care needs. People told us they had been involved in decisions about their care and we saw that staff were quick to consult other health professionals when necessary.

People were encouraged to maintain their independence and we saw examples of this during the inspection. We observed staff talking with and supporting people during our time in the home, we found that this was done with the person's privacy and dignity in mind. This demonstrated staff's awareness of people's individual support needs. This was also reflected in the support plans we viewed on the day.

Care plans were pictorial in nature and showed that people had had their needs assessed prior to admission and again on a regular basis. Through our discussions with staff, we found that they had a good understanding of what people’s care needs were and when they had changed.

Is the service caring?

People told us that staff were very caring and the evidence we reviewed confirmed that relatives felt their family members were well supported by staff. We found that people’s preferences were always well documented, and staff were able to tell us about the people in the home and their individual needs.

We saw that people were happy with the care and support they received. We observed that people were offered support at a level which encouraged independence and ensured their individual needs were met. Staff were relaxed, friendly and courteous in their approach to people and interacted confidently with them. Records showed that people were encouraged to express their views about the quality of care in the home and the pictorial care plans showed they were involved in planning their care, making decisions about their support and treatment, and how they spent their time.

Is the service responsive to people's needs?

No-one in the home needed a mental capacity assessment or a best interest decision at this time. Staff said they had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and all the training was current.

We noted that people's wishes were respected by care staff and taken into account when making best interest decisions, gaining consent and planning care and support. Records supported that the service engaged effectively with other professionals in ensuring that all areas of health and well-being were maintained.

The staff worked well with other health professional as was seen on the day of inspection. This meant incidents and accidents in the home were dealt with effectively.

Is the service well- led?

There was a registered manager in post. Staff were aware of their roles and responsibilities and were supported by the manager. None of the staff we spoke with had any issues or concerns about how the service was being run.

People living in the home were able to express their views and opinions about how the service was being run because there were meetings and other methods used to gain their views.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We were told that while no applications have needed to be submitted by the home, proper policies and procedures were in place. Staff understood when an application should be made, and how to submit one.

We found that the provider monitored the quality of the service provided to people and acted upon the feedback they were given. This showed that the service had an effective management structure and was responsive to concerns, making efforts to drive on-going improvement.

Inspection carried out on 7 June 2013

During a routine inspection

One of the people who lived at the home communicated by using an individual communication method. We were unable to ascertain what they felt about their experiences in the home but observed people’s daily routines and interactions with other people living in the home and staff, from a distance.

We observed staff talking with and assisting people throughout the day, this was done with the peoples’ privacy and dignity in mind and showed the staffs’ awareness of peoples individual support needs.

We looked at both the quality assurance questionnaires that were returned by people following their last care plan review. People were asked to make comment and return them anonymously if they wished. The feedback contained mostly yes and no comments, though both commented positively on other areas in the questionnaire. When prompted about being well informed about their daughters welfare; one person stated “Yes informally, and also by a monthly report. I am certain if there were any issues I would be informed.” The other stated “I am kept well informed at all times.”

When we spoke with staff they were aware how to support people and this reflected the support plans we viewed on the day.

Overall we looked at a number of outcome areas covering consent and agreement to care, support plans, nutrition, medicines, the environment, and the recruitment process.

Inspection carried out on 19 December 2012

During a routine inspection

We spoke with two people who lived at Alderwood LLA Ltd Westfield. They told us they were happy living at Alderwood LLA Ltd Westfield. Both people talked about going out regularly in the local area and about the interests and activities they did at home. We saw that people appeared calm and relaxed with staff and that staff had a good knowledge of people's care needs.

We saw that comprehensive assessments of the risks to individuals and other had been undertaken with written guidance on how staff should support people safely to reduce these risks.

Alderwood LLA Ltd Westfield was registered for treatment of disease, disorder or injury as well as accommodation for persons who require personal care. As the Alderwood LLA Ltd Westfield is a care home without nursing this regulated activity was not being provided. We discussed this with the nominated individual who stated they would apply to amend the registration. This inspection did not include treatment of disease, disorder or injury.