Archived: Alston House

Updated 15 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place unannounced on 28 September and we returned announced on 6 October 2017.

The inspection team consisted of an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert by experience had experience of dementia care.

We reviewed the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at information received from local authority commissioners. Commissioners are responsible for finding appropriate care and support services for people.

We reviewed the provider’s statement of purpose; this is a document which includes a standard required set of information about a service. We also reviewed the notifications submitted to us; these are changes, events or incidents that providers must tell us about.

We spoke with seven people using the service and three relatives. We looked at the care records of four people.

We also spoke with the registered manager, who is also the provider, the deputy manager, and three care workers, the cook and the housekeeper. We looked at two staff recruitment files. We also looked at records relating to all aspects of the service including care, staffing, training and quality assurance.

Updated 15 December 2017

This inspection took place unannounced on 28 September and we returned announced on 6 October 2017.

Alston House provides accommodation and personal care for up to 19 older people some of whom are living with dementia. It is located in Aylestone close to Leicester city centre. The service has bedrooms, some of which have ensuite facilities, on two floors accessed by a passenger lift and a garden at the rear. At the time of our inspection there were 17 people using the service.

The service has a registered manager. This 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.

People told us the staff were caring and kind. Staff communicated with people in a positive and compassionate manner. The atmosphere in the home was friendly and inclusive. People and staff listened to music together and one person enjoyed dancing with a staff member. Visitors were made welcome and staff spoke with them about how their family members were getting on.

Staff provided people with responsive and personalised care. Staff knew the people they supported well and understood their needs. We saw staff talking with people and making sure they had what they wanted. Staff told us that because their service was small they had the opportunity get to know the people they supported and how they liked things done.

All the people we spoke with said they felt safe at Alston House. Staff knew where people were at risk from falls or other accidents and took action to reduce the risk of harm. The premises were adapted to help keep people safe, for example people had call bells within reach and mobility and walking aids available to them. Staff were trained in safeguarding [protecting people from abuse] and understood their responsibilities to keep people safe.

People had mixed views about staffing levels at the service. Some people thought they were satisfactory whereas others felt there should be more staff on duty. Records showed staffing levels to be acceptable, given people’s needs, but the managers agreed to keep them under constant review and make changes where necessary to ensure people’s needs were always met in a timely manner.

People told us they had their medicines on time. Medicines were administered by trained senior carers. The managers carried out weekly medicines audits and took advice for their pharmacist and the local health authority to ensure people’s medicines were safely managed.

People said they thought most of the staff were well-trained. Staff completed a range of courses to help ensure they had the skills and knowledge they needed to provide effective care. The managers and staff had a working knowledge of the Mental Capacity Act and understood the importance of people consenting to their care.

People were positive about the food provided. We saw lunch being served on the first day of our inspection visit. The food appeared wholesome and well-presented. If people needed assistance or prompting with their meals staff provided this. The deputy manager carried out a monthly meals audit and made change to the menus in line with people’s wishes.

People told us staff supported them with their healthcare needs and accompanied them to appointments where necessary. People’s medical history and healthcare needs were documented in their care records so staff had the information they needed to help keep people healthy. Records showed people had access to a range of health care professionals including GPs, district nurses, chiropodists, and opticians.

People told us there were concerned about the lack of activities and outings at the service. They said this had left some of them feeling bored and unstimulated. Records showed activities were infrequent and mainly consisted of watching TV, listening to music, and board games. We have made a recommendation that the provider improves the service’s activities programme.

People said the managers and staff were approachable and friendly. Residents and relatives meetings were held every few months to get people’s views on the service. The managers carried out audits to help ensure the service provided good quality care in a suitable environment.

Although these were mostly effective, and had led to improvements, some issues with the premises had yet to be identified or addressed.