This inspection took place on 16, 17 and 24 September 2015 and was unannounced.
Alandale is a modern, purpose built residential home providing care for up to 35 older people, situated in the village of Whitfield on the outskirts of Dover. The home offers residential accommodation over two floors with large, open plan lounge areas, a conservatory and dining room on the ground floor. There is a stair lift and shaft lift for people to access both floors and there are no changes of levels on each floor, making the home suitable for people with mobility difficulties. There are 35 single bedrooms. 18 of the bedrooms have an en-suite toilet/washroom. There are seven toilets and three bathrooms with special facilities for wheelchairs and those of limited mobility. There is a small courtyard with seating and a back garden so that people can spend time outside in the finer weather and some off road parking spaces for visitors. At the time of the inspection 34 people were living in the home.
There was a registered manager working at the service. 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.
People and their visitors talked about their decision to move into the home. Some people had come in for a short break from their own home and found that they liked it. One person said, “I liked it so much I decided to stay here.” Another person said, “I was a bit worried about coming into a care home, but once I was here I decided I was better off here than at home. There is always someone around if you need them and I feel safe.”
People said the home was warm and friendly and it was like being in a large family. A person commented, “Since I’ve come in here, time has gone quicker because I’m not on my own. There is always someone here.” People’s friends and relatives had got to know each other and they said they enjoyed visiting the home. Various activities were organised each day and people and their relatives joined in when they wanted to or watched what was happening around them. Some people preferred to stay in their rooms most of the time and others liked to be in the lounges but preferred not to join in with the planned activities. Everybody said they felt there was enough to occupy them and their choices of whether to join in with activities or not was respected. Two parties were organised at Halloween and Easter each year to give people the opportunity to all get together with friends and relatives at the home and to meet everyone. Staff dressed up and everyone talked about how much fun it was.
There were plenty of staff to support people in the way they preferred. People said there was flexibility in the routines of the day and they could get up and go to bed when they wished. They said the staff had got to know them and they had the opportunity to let staff know their preferred way of being supported. People said they maintained as much independence as possible. Some people said they had mobility aids to get around the home and one person said, “My zimmer frame is a life saver I couldn’t manage without it but I always ask staff to walk with me just to make sure I don’t fall.” Staff supported people as much as they needed and at a respectful distance. There were clear plans of support and assessments to make sure risks were considered and strategies were in place to prevent unnecessary accidents.
There was a thorough staff recruitment process, including safety checks, so that the right staff were employed to work in the home. Staff were confident in their roles and had the training and support needed to make sure they had the skills and knowledge to be able to do their job effectively. Staff said the registered manager and owner were very supportive and always available if they had any concerns or needed advice.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Mental capacity assessments had been carried out to determine people’s level of capacity to make decisions in their day to day lives and for more complex decisions when needed. DoLS authorisations were in place, or applications had been made, for people who needed constant supervision because of their disabilities. There were no unnecessary restrictions to people’s lifestyles.
People told us that they felt safe living at Alandale. Staff had received safeguarding training and they were aware of how to recognise and protect people from the risk of abuse. Staff knew about the whistle blowing policy and said they could raise any concerns with the manager, the owner or outside agencies if needed. People said they were well cared for by the staff and nothing was too much trouble which made them feel reassured and content.
People were supported to keep well and healthy and if they became unwell the staff responded quickly and made sure that people accessed the appropriate services. Visiting health professionals including district nurses and doctors were involved in supporting people’s health and wellbeing as needed. Many people had lived locally and maintained the services including the same doctor’s surgery that they had always had. If people required treatment, for example, wound dressings from a district nurse, this was given in a way that respected people’s choice and preference. People’s medicines were managed safely. There were discussions and plans made with people and their representatives (nominated relatives/friends) so that people had the opportunity to say what they wanted if they were to become unwell.
Everyone said they enjoyed the food and mealtimes were set up to be social occasions or people could eat in their own rooms. Staff checked that people had enough to eat and drink and refreshments were available to people and their visitors throughout the day.
The owner and registered manager spent time with people and their representatives (nominated relatives and/or friends) to find out what they wanted and expected from the home and listened to any concerns. People, relatives and visiting professionals were also given surveys so that they could give feedback routinely each year and this could be returned anonymously so that feedback could be more open. From these discussions and the surveys, the owner and registered manager planned the priorities that formed the service development plan for the year. People said that the home was very well maintained. Improvements to what was provided to people and the upkeep of the building were ongoing. This year a new sluice room had been installed with improved equipment and various parts of the home had been redecorated. Following on from people’s views and suggestions the call bell system had been extended into more points in the lounge and staff had their names embroidered on their tunics so that it was easier for people and their visitors to know everyone’s names.
There was a clear complaints procedure and it was easy to make an anonymous complaint by picking up a form near the entrance. People and their visitors said they were happy to talk to the registered manager and staff if they had a concern.
Staff reported accidents and incidents to the registered manager who made sure appropriate action had been taken to reduce the risk of accidents happening again. The owner and registered manager checked for patterns and trends with accidents and incidents in the home overall and made sure that lessons had been learned and changes were made if needed.
Arrangements had been made to respond to an emergency. There was a folder of information including individual emergency evacuation plans and contact details of local services that would be able to assist.