Archived: Alderwood LLA Ltd Addington Road

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. People and relatives liked the staff and had developed positive relationships with them. Staff were motivated to provide kind and compassionate care. However, although staff knew people well, they did not always fully understand or attempt to understand the reasons which led to people becoming distressed or respond in the correct way. We observed staff asking a person to calm down when they were upset and while the intention of this statement was good, this intervention was ineffective and did not provide reassurance or comfort. As well as this we saw records describing incidents of distress which used punitive language and demonstrated a lack of understanding of the person’s experience. The layout of the premises did not always promote respect or privacy and dignity. Some people had a 2 to 1 staff ratio during the day, this meant people had 2 staff with them in a small space throughout the daytime. There was no separate space for staff within the main building to enable staff to move away if the person required any quiet time. The fire alarm reset button was with a person’s private accommodation, this meant staff had to access this person’s room to reset whenever the fire alarm sounded, this did not promote or respect privacy and dignity. Some areas of the service were unappealing, and did not maintain people’s dignity. However, some redecoration had taken place. Staff had involved and consulted people about preferred colour schemes. Staff knew about the things people enjoyed doing for leisure. There were times when drivers were not available so people could not access activities away from the service and this did at times result in people becoming distressed. The Registered Manager and staff demonstrated care, kindness and consideration to a person using the service who was dealing with significant emotional family matters.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths and abilities. People’s assessment and support plans contained information about their unique backgrounds and the things important to them. However, because new documentation regarding support had been introduced and not yet fully embedded, information was not always easy to find. Some of the documents designed to capture this information were not completed but had been completed in other documents. Staff knew people well and mostly knew what was important to them. We were given examples of people being supported with their cultural, religious and social needs. For example, attending religious places of worship, having access to appropriate cultural food and activities. Monthly keyworker meetings were used to develop opportunities for people. During our site visits people were supported to take part in the social activities they enjoyed. Staff had received training in equality and diversity. People and relatives, we spoke with were confident staff provided care and support to meet their family members needs. Relatives told us their family members took part in activities they enjoyed.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

People were supported to maintain contact with their family, this included visiting and overnight stays with their family members. However, there was no communal area for people to enjoy time together or to meet up with friends. The Registered Manager told us people did spend time together in the garden and did meet up with friends at the provider’s other locations, however this was not part of people’s regular routines or support plans and opportunities were for this were limited during winter time.

Some action had been taken to promote people’s independence such as reducing staffing numbers for some activities outside of the service. However, further progress was required. The Registered Manager and staff were in the process of changing the culture of the service to improve the promotion of people living empowered lives, but this had not been fully embedded or progressed.

People were given day to day choices of what time they got up / went to bed, what clothes they wore, they were offered a choice of meals and drinks, and how they spent their day including activities outside of the service.

The provider did not always understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or take enough action to minimise any discomfort, concern or distress.

People were mostly supported by staff who knew them well. However, staff did not always fully understand the cause of people’s distress or take effective action in time of distress. We did observe staff using effective interventions and following positive behaviour support plans, but this was not consistently the case. Positive behaviour support plans did not clearly set out the roles and responsibilities staff should take in response to incidents.

People had access to staff members at all times if they required immediate help or support.

Seventy three percent of staff had completed training about emergency first aid and basic life support. This training was part of the provider’s mandatory training package so compliance was low and we could not be assured there would always be staff with this training available to people.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff told us the registered manager was very supportive and always available. Some relatives and staff felt action from the provider’s senior management team was not available or delayed.

There was a lack of space for staff to take breaks, complete paperwork or gather for team meetings and handovers. The staff offices were within a garden building, and which was small. The staff toilet was accessed from outside which was not ideal, especially in the wintertime. The provider told us staff had not raised this as a concern.

De-briefs did not always take place to support staff following incidents of distressed behaviour, to enable reflection and learning or to check on staffs’ emotional wellbeing. Staff supervision had also not been taking place at the required frequency. However, action had been taken to remedy this.

The provider had an equality, diversity and inclusion policy to promote the protection of staff with protected characteristics under the Equality Act 20210 and to promote fairness and transparency.