Archived: Alvaston House Care Home

Alvaston House Care Home is a 17 bed residential home providing personal and nursing care to 11 people at the time of the inspection. The care home supports people in an adapted building.

The service rarely applied (didn’t apply the full range of) the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons; lack of choice and control and limited independence. People did not have choice in the food they ate or at what times meals were served. Menus were developed by staff with limited input from people who lived at the service.

The care service should be developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Health and safety checks were not regularly completed or evidenced to ensure risks to people’s safety were minimised. We brought some health and safety issues to the attention of the acting manager on the first day of our inspection visit where we had immediate concerns to people’s safety. Staff recruitment procedures were adequate which ensured people were cared for by staff who had been assessed as safe to work with them. People’s health and welfare was placed at risk from an environment that was not risk assessed in line with people’s life history and the risks associated with that. There were no adequate infection control checks in place which resulted in a heightened potential for cross infection and cross contamination of infection in the home. The environment was in need of cleaning and some areas disinfected, there were areas of malodour that required attention.

The provider did not have effective systems in place to assess the needs of people prior to entering the home. People were (not) supported to have maximum choice and control of their lives and staff (did not support) supported them in the least restrictive way possible; the policies and systems in the service (did not support) supported this practice. Staff did not understand the Mental Capacity Act 2005 (MCA). Staff confirmed they had not been trained to care for people with enduring mental health needs, and no training records existed to confirm what training staff had completed. There was no system in place that allowed the acting manager to consistently supervise the staff to ensure people were safe in the home. People could cater for themselves and others were provided with a varied menu which met people’s cultural needs, but choice was limited.

Staff observed people’s privacy and dignity, but did not recognise they were employed to respect people’s environment and not intrude on their personal space. Staffing levels were adequate to provide basic levels of care.

The provider did not have effective systems in place to assess, monitor and improve the quality of care. Care plans provided limited information for staff that identified some people’s support needs, however there was little information about people’s associated risks. There was enough staff on duty to respond to people’s health and care needs, however, social care and pastimes were not seen as a priority and people were not supported with these. There was no complaints process or records in place. Staff had not considered people’s end of life choices or made reference to this in care plans.

There was no evidence that any quality monitoring had been undertaken. The audit systems had not been put in place by the registered manager to ensure people received a quality service. Incidents were recorded but information was not always sent to CQC. Improvements are required in assessing risk to people. There was no access to policies and procedures which would give staff the information to operate systems effectively and protect people in the home.

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

This service was registered with us on 25/05/2018 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about allegations of financial irregularities. A decision was made for us to inspect the home but not look at the allegations and incidents that were subject to a Local Authority investigation.

Enforcement

We have identified breaches in relation to the safety of people in the service, safety and monitoring of the environment they live in. There are further breaches around assessing people’s needs and the composition of care plans and the risks associated with caring for people.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. We have assessed the inspection outcome is so serious that people are placed at risk. We propose to cancel the provider’s registration, and are in contact with the local authority to identify alternative accommodation.