We carried out a review of the data available to us about Alderson House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Alderson House, you can give feedback on this service.
Alderson house is a residential care home providing personal and nursing care to 17 people with mental health issues at the time of the inspection. The service can support up to 18 people.
People’s experience of using this service and what we found
There were systems and processes in place to monitor the quality of the service, however, these were not fully effective. We found some inconsistences with information in care plans and the audits around some areas of practice were not robust.
People were safe at the service as staff understood their roles in managing any possible safeguarding issues. The risks to people’s safety were assessed and measures in place to mitigate risks and keep people safe.
People were supported by sufficient numbers of staff who received training for their role. The provider undertook safe recruitment processes to ensure people were supported by a suitable staff group.
People received their medicines from staff who had been trained to safely administer medicines. Staff employed safe practices to control the risks of infection at the service and there were processes in place to learn from incidents and accidents to reduce the risk of reoccurrence.
People’s nutritional and health needs were well managed and the environment they lived in was well maintained. The service had a number of communal areas for people to use, both inside and outside the property. There was also equipment for people to follow their hobbies and enjoy their environment.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported by a caring staff group who respected their choices. People had the opportunity to voice their opinions on their care and were supported when needed with the services of advocates.
People received care in a personalised way, staff we spoke with showed a good understanding of people’s needs. However, the information in their care plans did not always support this. The management team were aware of the need to review and improve the information in people’s care plans and were already working to address this.
People were supported to maintain relationships with their families, follow their hobbies and be involved in social activities. Information was provided in ways people could understand and there was clear information around the service to support people should they wish to make a complaint.
People and staff told us the registered manager and other senior managers were approachable, and both people and staff were able to voice their opinions about the service and felt they were listened too. The registered manager worked to provide an open person centred approach to people’s care and worked with other health care professionals to achieve this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 28 March 2018).
Why we inspected
This was a planned inspection based on the rating at the last inspection
• The service is in a rural setting, near to Mablethorpe in Lincolnshire.
• The service provides accommodation and personal care to people with mental health issues. The care home can accommodate 17 people in one building. At the time of our inspection there were 15 people living in the service.
People's experience of using this service:
• People were assisted to have choice and control over some aspects of their lives, though there were issues about some people’s ability to choose their own lifestyle.
• Heating levels were not always adequate to keep people warm.
• Audit processes were not comprehensively in place to ensure quality care. Questionnaires had not recently been supplied to people and their representatives for their views of the service.
• The service provided was safe.
• Most people told us that people liked living at the service.
• People were protected against abuse, neglect and discrimination. Staff members were aware of ensuring people's safety and acting when necessary to prevent any harm.
• Staff members knew people well and most people appeared to enjoy the attention from them.
• People's care was personalised to their individual needs.
• A registered manager was in place, which is a condition of registration.
• The service met the characteristics for a rating of "Good" in key questions except caring and well led, where it was rated Requires Improvement.
• More information is in the full report.
Rating at last inspection:
• At our last inspection, the service was rated "good". Our last report was published for the inspection of 15 March 2016.
Why we inspected:
• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
• We will continue to monitor the service to ensure that people received safe, high quality care. Further inspections will be planned for future dates.
People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.
CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of our inspection there was no one subject to such an authorisation.
Staff had taken an outstanding amount of care and preparation in finding out what people wanted from their lives and had supported them in their choices. This sometimes had taken a lot of weeks of preparation and setting up, but staff remained consistent in their approach and ensured the outcomes were what each person wished. They had used family and friends as guides to obtain information and accessed a number of different resources within the community. Staff had outstanding skills and an excellent understanding of the social, cultural, values and beliefs of the people at Alderson House.
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We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.
We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.
People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.
People had a choice of meals, snacks and drinks. And meals could be taken in dining rooms, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it. Some people helped with the preparation of meals and setting tables for meals.
The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.
People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements.
We looked at care plans which recorded people's assessed needs and specific risks. These had been updated on at least a monthly basis. People told us they knew staff kept notes on them and had their needs discussed. One person said, "Staff talk to me at all times about my care."
The records showed that people had been receiving their prescribed medication. The storage area was clean and tidy. Some staff had been trained to administer medication.and others were in training. People who used the service told us about their medication and how it was administered. One person said, "I prefer staff to keep my medicines locked away for me."
People who used the service told us there were sufficient staff on duty to meet their needs. One person said, "Staff are always around to take me shopping." Staff told us there were adequate numbers of staff to ensure they could meet people's needs.
The complaints process was on display and people who used the service told us they were confident any concerns would be investigated. One person said, "Staff will always listen to me."
Comments included, "I'm happy here", "I've got everything I need", "I know staff keep records on me" and "I feel safe here".
During the visit we spoke with visitors who expressed their satisfaction with the standards of care at the home. They told us the staff were good and they were kept informed of any changes.