Care Home: Alderwood LLA Limited (Irchester)

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What the care home 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. 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? There have been a number of improvements, that has connfirmed the excellent status of the home. What the care home could do better: The manager identified a number of areas in the AQAA that form the basis for the following improvements. Further develop `Learning for Life Skills` programme, fully embracing a person centered service creating a holistic provision for young adults with autism and complex behaviours. To continue to monitor, evaluate and update, care plans, activities and timetables and support social interaction and inclusion. To continue to listen and incorporate views and feedback from residents, their families, social workers, placement authorities, carers and stakeholders through our own robust internal auditing systems. Develop a more streamlined recruitment process and develop bespoke training for each employee. Key inspection report Care homes for adults (18-65 years) Name: Address: Alderwood LLA Limited (Irchester) 170 Station Road Irchester Northamptonshire NN29 7EW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Williamson     Date: 1 0 1 1 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 25 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 Homes for Adults (18-65 years) 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. 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 Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Alderwood LLA Limited (Irchester) 170 Station Road Irchester Northamptonshire NN29 7EW 01933312315 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: alderwoodlla@aol.com Alderwood LLA Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of services who can be accomodated is: 6 The registered person may provide the following category of service only: Care home only-code CRH To service users of the following gender: either Whose primary care needs on admission to the home are within the following category: learning disability-code LD Date of last inspection Brief description of the care home The home is located on the edge of the village of Irchester, Northamptonshire, with good access to local bus services and major road networks. The home is a large five bedroom detached property with ample parking space to the front and a large wellestablished garden to the rear. There are five good-sized individual bedrooms complete with ensuite facilities and an additional shower room. A double garage to the front of the property provides an office and educational/activity resources. Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 6 Brief description of the care home Weekly fees range from £4041 to £5704 dependent upon the individual level of support required. Copies of the latest CQC reports are available from the staff at the home. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections is on outcomes for people who use the service and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, looking at their records and accommodation, in this case three people 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 people, 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 people, home and the staff group. Surveys were sent to people and staff, though comments were received from staff and have been added to this report. Care Homes for Adults (18-65 years) Page 6 of 25 Four staff were spoken with, and all the people were seen, and their exchanges with the staff group observed. The quality rating for this service is 3 star. This means the people who use this service experience Excellent quality outcomes. Care Homes for Adults (18-65 years) Page 7 of 25 What the care home does well: 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. Care Homes for Adults (18-65 years) Page 8 of 25 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are offered a tailored introduction to the service 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 which also includes the complaints procedure is available in a number of different formats pictures and spoken translations. This ensures everyone in the home can understand it. 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. People moving into the home can take two years to complete the transition. The process is clearly directed to suit the individual, ensuring the move is well planned and seamless. Care Homes for Adults (18-65 years) Page 11 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans are individual and risk assessed appropriately 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. Staff ensured that appropriate action was taken to reduce the possibility of challenging situations. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 encourage people to develop a healthy and meaningful lifestyle based on self help skills. Evidence: We looked at the life plans of people. These showed us people experienced a rich and varied education and social life. People now have individual programmes geared to their Independence, self care and socialising. An activities organiser has been recently employed to assist in this process. Service Users undertake a wide range of activities assisted by staff, both at the home and in the local area. Again these are tailor made for people to assist in their personal development Service Users are introduced to holidays, with caravans in various areas of the Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: country. Again stays are tailored to the persons individual needs, and stays arranged on an increasing basis. This ensures the person is introduced to the holiday environment at a pace they can tolerate. 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. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 continue to have their health and medication needs met appropriately 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 act appropriately. The staff group also includes a psychologist who assists in the care planning and healthcare of people in the home. We looked at the way staff give out medication and found that staff are administering medication safely to people. The policy and procedures followed by the staff are very comprehensive. These tell us that there are two staff giving out medicine at one time, and both staff sign to confirm that it has been taken. More importantly there are details on what the staff must not do. Overall this makes process very safe, and is Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: above the minimum required. We saw staff records and these showed us that staff have undertaken training in the administration of medication. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good 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. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 live in a purpose built, safe and secure environment 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 individually constructed to the needs and preferences of the people using them. This included many personal items such as family pictures and electrical goods. 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. 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. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 continue to be supported and protected by the homes recruitment practices and number of staff on duty. Evidence: We saw excellent 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 talked to staff and saw them communicating with people in a manor suited to the individual. People have at least one to one support during the day, this ensures peoples 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 and regular supervision. 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 with challenging behaviour. Training is organised from in house as well as external sources, and staff have written tests following the courses. This indicates senior staff monitor how well Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: staff perform within the home, and arrange further training accordingly. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is safe and well managed 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 many levels Quality Assurance(QA) and monitoring systems in place, and we noted a number of these. Staff are currently reviewing the style of the questionnaires and hope to have them in a more user friendly format the next time they are used. Other forms of QA include feedback from parents and professionals, regular staff checks on the building and visits from senior managers. 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 Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: 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. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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. 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. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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