Archived: Applethwaite Green

We found the following examples of good practice.

Staff had been trained in infection prevention and control and on safely using and disposing of Personal Protective Equipment (PPE). The provider had ensured sufficient quantities of PPE were available. Staff had their practice observed to help ensure their competence.

The registered manager made sure clear information about maintaining social distancing and hand hygiene was highly visible on entry and throughout the home to guide staff and visitors. The registered manager had followed government guidance about visiting. Relatives had been supported to visit people safely and also stay in contact electronically and by telephone.

The registered manager followed best practice around safe admissions when people came into the home. The registered manager had arranged for regular COVID-19 testing for staff and people who lived in the home.

Staff were allocated to work in specific areas of the home using separate entrances and facilities to reduce the risk of transmission of infection. Risk assessments have been carried out on people using services and staff belonging to higher risk groups and actions have been taken to help reduce the risks.

The registered manager kept staffing arrangements under review and during the outbreak had been supported by agency staff specifically allocated to the service. The domestic staff team had increased to ensure deep cleaning took place and keep the home clean and hygienic. Cleaning records and audits on cleanliness and infection prevention showed frequently touched surfaces were cleaned regularly.

The registered manager had robust contingency plans and local authority guidance in place to help ensure the safety of the service during the pandemic.

Further information is in the detailed findings below.

Applethwaite Green is a residential care home that provides personal care and accommodation for up to 27 people. At the time of our inspection there were 14 people living at the home. Accommodation is over two floors, with people living in units each with a communal lounge and kitchen/dining area. The ground floor unit provides care and accommodation for people who are living with dementia.

People’s experience of using this service and what we found

People told us they felt safe living at Applethwaite Green. They were cared for by enough care staff, who had received training on safeguarding people to keep them safe from avoidable harm. People told us when they needed assistance staff responded promptly. People received their medicines as prescribed and systems were in place for the safe management and supply of medicines. Risks to people were assessed and incidents and accidents recorded and analysed for themes. The premises were clean and hygienic and staff followed infection control and prevention procedures.

People were supported by staff who were trained and supported in their roles to help people to live healthy lives. The service worked with other organisations to make sure people had consistent care and treatment and access to professionals and support services as needed. People were given a choice of a varied and nutritious diet. 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 positive about the service and the care provided and felt staff listened to them. People were cared for by staff who were open and kind. The atmosphere within the home was friendly and welcoming and staff promoted people’s independence and personal dignity.

Staff provided care and support tailored to people's needs and choices. Staff knew them well and helped them pursue their own interests and take part in activities and entertainments they enjoyed. People were supported at the end of their life with compassion, to be comfortable and free from distressing symptoms and pain. Systems were in place to deal with any complaints raised about the service.

The registered manager displayed knowledge about the needs of the people who lived at Applethwaite Green. They displayed an understanding of the importance of good quality monitoring, openness and transparency and working closely with other agencies and healthcare professionals. People who used the service and staff said the registered manager was available and approachable and their views were sought to improve aspects of the service.

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 good (published 21 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Applethwaite Green on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Applethwaite Green is located in a residential area of Windermere and is within walking distance of the local shops and amenities. The home provides accommodation up to 28 older people living in three units each with a communal lounge and kitchen/dining area. The ground floor unit provides care and accommodation for people who are living with dementia. There were 21 people living at the home at the time of our inspection.

There was a registered manager in post at the time of the inspection. 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.

One person living at Applethwaite Green told us that the home was “safe and clean”. We saw that the people who lived there were relaxed and comfortable in the home and with the staff that were supporting them. The atmosphere was informal and inclusive and everyone we spoke with praised the work of the staff that supported them. People who lived there told us they were "safe" and "happy" living in the home. Relatives we asked rated the care in the home as “excellent”.

We saw that the staff offered people assistance but respected their independence. We saw that staff took the time to speak with people and took up opportunities to interact with them, engage and offer reassurance if needed. People we spoke with who lived at Applethwaite Green told us that they felt that they were being involved how in how they wanted things done in their home.

We looked at the way medicines were managed and handled in the home. We found that medicines were being administered and records were being kept of the medicines kept in the home. We have made a recommendation about the management of some medicines. We have recommended that a formal risk assessment of the storage areas be done and a formal procedure put in place on maintaining temperatures. This is so all staff involved in the management of medicines know exactly what the registered providers wants them to do to mitigate the risk and the procedure to be followed is in the event of temperatures being unsafe for the storage of the medicines.

People knew how they could complain about the service they received and information on this was displayed in the home. People we spoke with were confident that action would be taken in response to any concerns they raised.

The environment of the home was welcoming and the communal areas had been arranged to make them homely. We found that all areas of the home used by the people living there were clean. People told us they had a choice of meals, snacks and drinks. The people who lived there told us that the food was good and that they enjoyed their meals. Relatives we spoke with told us that they did not have any concerns about how their relatives were being supported and looked after by the staff in the home.

The care plans and records that we looked at showed that people had been seen by appropriate professionals to help meet their particular physical, nursing and mental health needs. We saw that the assessment and management of risk had been reviewed and updated by staff so that people received appropriate support and treatment.

We saw that there were systems in place to assess the quality of the services provided in the home and a programme to monitor or ‘audit ‘service provision.

We found that there were safe recruitment procedures and practices in place to help ensure staff who were employed were suitable for their roles. All the staff we spoke with knew the appropriate action to take if they believed someone was at risk of abuse. This had been part of the training staff received to be able to carry out their roles. We saw that care staff had received induction training and on going training and development and had supervision once employed.

The service followed the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who were not able to make important decisions themselves.