Inspection on 12/08/09 for Alderwood LLA Ltd

This is the latest available inspection report for this service, carried out on 12th August 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report CARE HOME ADULTS 18-65 Alderwood LLA Ltd 302 Wellingborough Road Rushden Northamptonshire NN10 6BB Lead Inspector Keith Williamson Key Unannounced Inspection 12th August 2009 09:00 Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Alderwood LLA Ltd Address 302 Wellingborough Road Rushden Northamptonshire NN10 6BB 01933359061 01933359061 alderwoodrushden@hotmail.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Alderwood LLA Limited Mr Harold Martin Kelvin Noel Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief Description of the Service: This is the first visit to this home. The home is an adapted property with accommodation for Service Users all being on the ground floor. It is bright and airy and furnished in a homely manner. Service Users rooms are large and all have ensuite facilities or a designated bathing area. It is situated in a residential area of the town, close to the shops and bus routes. Transport is provided by the Homes’ own minibus. Accommodation is provided for up to five younger adults, of either sex, who have a learning disability as well as physical disabilities. The current fees range from £5000 to £6000 per week according to the individuals assessed need. Included in the cost is the use of holiday facilities in Lincolnshire, Northamptonshire and Devon. Copies of this and future Care Quality Commission reports shall be available from the staff at the home. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections is on outcomes for Service Users and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of clients and tracking their care they received through talking with them, where possible and looking at their records and accommodation, in this case three Service Users were chosen. This visit took place over one day, commencing at 9.30pm and took six hours to complete. An opportunity was taken to observe the Service Users, talk with the Manager and staff, look around the home, and view records, policies and care plans. Information was also obtained from the Annual Quality Assurance Assessment (AQAA), which gives information on the Service Users, home and the staff group. Comment cards were sent to the Service Users and staff, no comments were made by Service Users, comments from staff have been added to this report. Four staff were spoken with, and all Service Users were seen, and their exchanges with the staff group observed. This is the first visit following registration with the Care Quality Commission. The home was previously registered with Ofsted, as a school, and received outstanding school awards for there previous two reports. Due to the sustained high quality service offered to the Service Users in the home, we have also judged this an excellent service. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. What the service does well: The service is homely, and there is a family atmosphere at the home. The bedrooms reflect the personal preferences of the people who use them. Staff receive excellent training and regular supervision to support them in the work they do. Staff were observed to have an excellent understanding with people who live in the home, and clearly knew how to respond to their needs. Care plans are very detailed, person centred, and support excellent health and personal care. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 6 People living in the home have a rich and varied life, being supported in undertaking a range of activities to suit their needs and preferences. The providers are very conscious of health and safety, and there are good recording systems in place to ensure that health and safety needs are met. The service has good links with other health and social care professionals, and uses these to support the needs of people living in the home. The staff group are employed in numbers sufficient to assist people individually. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Significant time and effort is spent planning to make admission to the home personal and well managed. EVIDENCE: The staff have developed a comprehensive statement of purpose and service users guide, which is very specific to the current group of people in the home. The information is available in a number of different formats which allows everyone in the home to understand it. This is produced including pictures and spoken translations. The complaints procedure is also included in the different styles of the guides. People have their needs assessed in detail prior to moving into the home. The assessments seen were very detailed, and included continually updated information, recognising any changes in the persons abilities and needs. A great deal of planning goes into moving people, with staff from Alderwood visiting and working with people well before any move is made. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. EVIDENCE: We looked at the care records of people. We found them to be very detailed and descriptive of the care and support offered to people. Care plans are adapted into a format more easily understood by people who live there. We saw that care records were routinely up-dated to ensure they reflected the changing care needs of people living in the home. We saw that staff have a good understanding of the risks relating to each person who lives there, and have put risk assessments in place to reduce risks associated with each person. During our visit we observed staff being very mindful of how people might react to the change in events our visit caused. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 10 Staff ensured that appropriate action was taken to reduce the possibility of challenging situations. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff understand the importance of people to achieve their goals, follow their interests and be integrated into community life and leisure activities. EVIDENCE: We looked at the life plans of people. These showed us people experienced a rich and varied education and social life. People have continuing education in the home, and this is also geared toward learning life skills. Part of the staff group are qualified teachers, this assists greatly in the education programmes of people. People undertake a range of activities assisted by staff, both at the home and in the local area. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 12 Holidays are also catered for, with caravans in various areas of the country. The Service Users family are also encouraged to attend, with similar accommodation provided close by. We saw that staff are sensitive to the individual needs of people living at the home. They were aware of the preferences of people in terms of where they prefer to sit in the home, and when they like to have company or be alone. We saw staff talk to and interact well with people who live there. Staff also were aware of how to effectively communicate with each person. We saw the menu for people, this reflected their individual needs. The menus are all very similar, but there are adaptations to ensure the individual needs of each person are being met as detailed in their care plan. The menu provides a balanced and healthy diet. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans clearly record people’s individual personal and healthcare needs and detail how they will be delivered. EVIDENCE: We looked at the personal and healthcare records of people. We saw that they have good access to healthcare services to meet their personal and healthcare needs. On talking to staff as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a good quality of life for those concerned. Staff use very advanced and innovative ways to communicate with people. Staff are able to tell changes in moods and recognise events such as the person experiencing pain. The staff group also includes a psychologist who assists in the care planning and healthcare of people in the home. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 14 We looked at medication management and found that staff are administering medication properly to people who live at the home. We also noted that medication is stored safely. We saw staff records and these showed us that staff have undertaken training in the administration of medication. Staff commented on what the home does well, “really cares for the young men who live there”. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure that is clearly written and easy to understand and would enable people to raise concerns if needed. EVIDENCE: We looked at the complaints procedure and saw that this was written in a way which is more helpful for people living at the home to understand. We saw very good interaction between people who live in the home, and staff who support them. We were told in the AQAA that the views of people living in the home are important, and that the service wants to get it right first time. We saw by looking at staff training records and by talking to them that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way. We also saw by looking at staff records, by talking to and observing staff that they understand how to work with people with challenging behaviour. People who live in the home have their own bank accounts. Staff support people living at the home in being responsible for their money. We checked the financial records at the home, and found accurate recording of money balances. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 & 30 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home, live in a homely, comfortable environment, which is personalised to their needs. EVIDENCE: We looked at the communal areas of the home and the bedrooms of people who live there. We found the communal areas to be very well decorated and homely. The bedrooms were decorated individually to the preferences of the people using them, and included many items personal to them. The staff have a detailed maintenance and renewal programme for furniture and fittings in the home. This is continually updated, as part of the quality control in the home and we saw how that translated in the home being well maintained. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 17 The home is run for the people who live there, with areas being “colour coded” so people are given visual prompts as to the time of day and what activity comes next. Staff are aware of hygiene and how to control the spread of infection. This is important as it keeps people safe in the home. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has plentiful staff available at all times to support the needs, activities and aspirations of residents in an individualised and person centred way. EVIDENCE: We talked to staff and saw them supporting people who live in the home. We saw very good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. We saw excellent levels of staff support, and detailed non verbal communication, with people living at the home having at least one to one support during the day. This ensures people’s needs are being met by a regular in put from staff. All staff said they were supported well to do their job, through induction training, on going training relating to the job they do, and through regular supervision. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 19 We looked at a sample of staff recruitment records, and saw that all the necessary checks were made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken a wide range of training to help them in their roles, some of this before working with service users. Training included health and safety, medication management, working with autism, and working with challenging behaviour. Training is organised in such a way that courses are obtained from in house as well as external sources, and some ensures how aware staff are by having written tests following the courses. This indicates senior staff monitor how well staff perform within the home, and arrange training accordingly. Staff commented on what the home does well, “Teaches the staff and offers the necessary support to help make a difference to their (service users) lives”, and “I feel part of a team that is doing a good job, I am learning something new every day”. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of ‘best practice’ operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. EVIDENCE: The registered manager has been in charge at the home for a number of years and has the experience and qualifications to provide a suitable and safe environment for people living there. There are quality assurance and monitoring systems in place, and we saw the last audit undertaken by the owners. We were informed that they have Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 21 reviewed the style of the questionnaires and hope to have them in a more user friendly format the next time they are used. Outcomes from the quality assurance monitoring is made available to people in the home, their representatives and those considering coming to stay at the home. This comes in a number of formats which people can understand. We viewed a number of the policies and procedures that are produced by the parent organisation. We were satisfied that these provide good guidance for the staff to operate safe working practices. We looked at a number of tests the staff do to monitor areas such as the fire detection system, the hot water regulating system, and other areas such as electrical testing. These were up to date and showed us the staff monitoring helps keep people safe in the home. Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 4 32 X 33 4 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X X 3 X 3 X Version 5.3 Page 23 Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Are there any outstanding requirements from the last inspection? Not applicable STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alderwood LLA Ltd DS0000073248.V377545.R01.S.doc Version 5.3 Page 24 Care Quality Commission East Midlands region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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