Alderwood 2 - Hillcrest 2

Updated 5 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection was carried out by two Inspectors on the 6th November 2018.

This inspection was announced. We gave the service 48 hours’ notice of the inspection visit because the location was a small care home for younger adults who are often out during the day and needed to know we would be visiting and that the registered manager and staff would be available.

Before visiting the service, we looked at previous inspection reports and information sent to the Care Quality Commission (CQC) through notifications. Notifications are information we receive when a significant event happens, like a death or a serious injury. We also contacted health and social care commissioners who place and monitor the care of people living in the home.

We also looked at information sent to us by the manager through the Provider Information Return (PIR). The PIR contains information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

People living at Alderwood 2- Hillcrest 2 had some communication difficulties due to their learning disability and/or mental health. However, we were supported by staff to spend time with people, observing their daily routines, and observing any support being provided. This helped us gain a better understanding of people and the care they received at Alderwood 2- Hillcrest 2.

We spoke with three relatives of people who used the service, four members of care staff, the registered manager, the operational manager, the director, the training and human resources manager, and the staff mentoring lead.

We looked at three peoples care records to ensure they were reflective of their needs, three staff files, and other documents relating to the management of the service, these included, daily monitoring forms, positive behaviour support plans and medicine administration records.

Updated 5 January 2019

The inspection took place on 6th November 2018 and was the first inspection of the service since they registered with CQC in November 2017.

Alderwood 2- Hillcrest 2 is a small residential care home registered to provide care for up to six people with learning disabilities and autism. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. On the day of the inspection there were three people living in the home.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service has a Registered Manager. 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 living at Alderwood 2- Hillcrest 2 had a range of complex care needs and required a high level of support with daily living inside and outside the home. We met all three people during our visit and were able to observe interactions that evidenced their daily routines and plans.

People were supported and encouraged to lead a fulfilling life and have choice and control over their care, environment and activities. People felt a part of their community, and could take pride in their achievements.

There was a very positive and empowering culture within the service. The management team provided strong leadership and led by example. Relatives, staff and other agencies were very positive about the leadership of the service. They described the registered manager as "an asset", "supportive," and "positive.”

We observed positive and compassionate interactions between staff and the people they supported. Staff said they loved their work and were passionate about providing high standards of care. The provider inspired staff to provide an exceptional quality service.

Risks in relation to people’s care were assessed, understood and managed well. Staff worked hard to manage risks, whilst not restricting people’s opportunities. People were encouraged to lead active lives and were supported to participate in community life as much as possible.

Personalised care was central to the homes philosophy and staff demonstrated they understood this when talking about how they met peoples personalised care and support needs. People’s care records and support arrangements were highly bespoke, which ensured care was tailored to meet their individual and diverse needs. We saw people were enabled to live a happy rewarding life, to feel safe, enabled to try new opportunities, achieve goals and reach their potential.

Systems were in place to identify what each person wanted to achieve, and how best to support them to do this. Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.

People's safety was paramount in the service. People were supported to understand how to keep safe. Training for peoples on safety topics such as, keeping safe in the community, bullying and hate crime, sexual health and relationships was delivered.

Professionals involved in people’s care confirmed that the service was attentive to people’s needs and had been able to meet People’s complexities of need where other services had been unsuccessful. Staff were innovative in finding ways to ensure that a person received the medical treatment that they needed and they had taken inventive steps in complying with the accessible information standard.

The service is involved in the development of a national initiative to try and prevent the over medication of people with learning disabilities, autism or both and this attitude was embedded within the service. The provider has been awarded for educating the wider community about positive approaches to autism, and for the on-going investment into the strong development within their staff team by external bodies.

Staff understood abuse and the safeguarding procedures that should be followed to report abuse. Safeguarding procedures were followed correctly and alerts made when required.

The staff recruitment procedures ensured that appropriate pre-employment checks and disclosure barring checks were carried out to ensure only appropriate staff worked at the service. Accurate staffing levels were in place.

Staff induction training and mentoring was extensive and on-going training was provided to ensure that staff had the skills, knowledge and support they needed to complete their roles to a high standard.

The management team had systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required. The service considered people’s feedback and was continuously trying to improve the service and provided inclusive care.