Archived: Alderson House

Alderson House is a residential care home providing personal care for 25 people aged 65 and over at the time of the inspection. The service can support up to 32 people.

Alderson House provides support to people with sensory impairment, physical disabilities and people living with dementia.

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

People received safe care. Safeguarding policies and procedures were in place to help protect people from harm and abuse. Management of people’s medicine was robust. Staffing levels were monitored and there were enough skilled and experienced staff to meet people’s needs. Minor issues with infection control in the laundry were quickly addressed during the inspection. Staff followed infection control practices.

Staff received appropriate induction, training and support and applied learning effectively in line with best practice. This led to good outcomes for people and supported a good quality of life.

Where risks to people’s wellbeing had been found detailed person-centred care records were in place to inform the staff about the care people needed to receive. People’s care was reviewed and monitored as their needs changed.

People had their capacity assessed and were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were caring and kind. People we spoke with and their relatives confirmed this. Staff provided comfort and support if people became anxious or upset. Information was provided to people in a format that met their needs in line with the Accessible Information Standards.

Staff supported people to meet their health and nutritional needs. People were supported and encouraged to maintain their independence. Staff worked with health care professionals to maintain people’s wellbeing.

People felt able to raise concerns. issues raised were investigated and this information was used to improve the service. There was a good programme of activities in place. Community links were promoted. Dignified end of life care was provided. Compliments about end of life care had been received.

The service was well-led. Continuous improvement, learning and innovation had been implemented. The registered and deputy managers supported the staff team and they all worked together. Quality checks and audits had been improved since the last inspection and they were undertaken to monitor the service provided. Action plans were created when shortfalls were found to make sure corrective action was taken. Data security was maintained.

People living at the service, their relatives and staff had the opportunity to provide feedback about the service.

Rating at last inspection and update

At the last inspection the service was rated requires improvement with two breaches of regulation, report published on 23 June 2018. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the rating at the last inspection.

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

Alderson House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection. Alderson House supports up to 32 people, some of whom may be living with dementia, have a physical disability or a sensory impairment. At the time of the inspection, there were 20 people who used the service.

The service had a registered manager. 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.

A small number of people had not received their medicines as prescribed. This was due to errors in staff calculating when specific pain relief patches were due and on one occasion when staff were unable to locate a medicine. There were some minor recording issues and clearer guidance was needed for staff when people were prescribed medicines on a ‘when required’ basis.

This was a breach of Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. You can see what action we told the provider to take at the back of the full version of the report.

The provider had a quality monitoring system that ensured areas of the service and care provision were audited so improvements could be made and lessons learned. A new electronic recording system had just been introduced, which staff were not completely familiar with. This had meant some records such as food intake monitoring could be improved. Staff described the culture of the organisation as open and management as supportive and approachable.

Staff had received training and had procedures to guide them in safeguarding people from the risk of harm and abuse. In discussions, staff were clear about how they would escalate concerns and which agencies they would contact for advice.

Staff had completed assessments with people to identify risk areas and the steps required to minimise risk. Some risk areas had been overlooked and this was mentioned to the registered manager to address.

People’s health and nutritional needs were met. Records showed people had access to a range of community healthcare professionals for advice and treatment. These included dieticians when people lost weight and required additional support. The menus provided varied meals with choices and alternatives. People told us they liked the meals provided to them.

The staff supported people to make their own decisions and choices when they were able. When people were assessed as lacking capacity, staff consulted with relevant people when decisions were made on their behalf. The provider worked within mental capacity legislation to ensure deprivation of liberty applications were made.

People told us the staff had a kind and caring approach, and they respected their privacy and dignity. Staff asked people’s consent prior to delivering care. People could remain at Alderson House for end of life care if they chose this option.

There were activities for people to participate in but these could be improved. As they were currently provided by care staff, the provision could be disjointed when they were called away for personal care tasks. Recruitment was underway for an activity coordinator, which will resolve the issue.

Staff were recruited safely and checks were carried out before they started work in the service. There were sufficient care staff on duty to meet people’s needs. There were ancillary staff, which enabled care staff to concentrate on caring for people.

Staff received training, supervision and appraisal to ensure they were skilled and confident in meeting people’s needs.

The provider had a complaints procedure and people told us they felt able to raise concerns and these would be addressed by management.

The environment was clean, tidy and safe. Staff had access to personal, protective equipment which helped them to prevent and control the spread of infection.