Alderwood L.L.A. Limited - Dybdale Crescent

Updated 9 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector carried out the inspection.

Service and service type

Alderwood L.L.A. Limited - Dybdale Crescent is a care home. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received since the provider registered the service with CQC. We contacted the local authority commissioners and Healthwatch for information about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection

During the inspection

We spoke to the relatives of people about their experience of the care provided. Some people were unable to talk with us and used different ways to communicate including signs, pictures, gestures, vocalisations and body language. We spent time with people and observed the interactions between each other and with staff as part of our inspection visits.

We spoke with eight members of staff including the registered manager, regional manager, shift leaders and support workers.

We reviewed a range of records. This included one person’s care records and two medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, audits, minutes of staff meetings and quality assurance records.

Updated 9 June 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Alderwood L.L.A. Limited - Dybdale Crescent is a residential care home providing personal care for three people at the time of the inspection. The service can support up to four people within the main home and one person accessing respite care within the self-contained adjoining annex.

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

Based on our review of key questions of Safe and Well-led. The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

Staff supported people to have choice, control and independence over their own lives. Staff supported people to develop strategies to manage emotional distress and anxiety, maximising safety so as to provide the best circumstances in which people could make decisions and experience an active and rewarding day.

Periods of anxiety or emotional distress were recorded, which included the action taken by staff to support people. The registered manager considered these as part of the review process of people’s needs.

People had been asked about their living environment and were in the process of choosing colour themes for their bedroom and communal areas.

Staff supported people to access health and social care support, which included a regular review of their prescribed medicines. Staff supported people with their medicines safely. Positive relationships had developed with local health care providers, who provided timely support, considering people’s emotional and sensory needs for planned appointments.

Right Care

People’s dignity and human rights were promoted, and people were encouraged to make day to day decisions about the activities and events they wished to participate in. However, phrases used to describe periods of emotional distress or anxiety were not always respectful.

Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. Staff had training on how to recognise and report abuse and knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Recruitment was ongoing to fill vacancies.

People could communicate with staff and understand information given to them as staff supported them consistently and understood their individual communication needs. People received care that supported their needs and aspirations and was focused on their quality of life.

Right culture

The provider sought the views of family members and staff through the sending out of surveys. However, most family members and staff had not received an outcome of the consultation process from the provider, or information as to planned actions in response to feedback. Surveys had recently been developed to seek people’s views using pictorial cards.

The provider’s policies which had recently been introduced were not fully implemented, they referred to the visions and values of the provider in creating a supportive, open and inclusive culture. Family members spoke of recent improvements in the culture of the service since the appointment of the registered manager. This had created a more open culture, with an emphasis on encouraging their relative’s to be involved in decisions about their care, and through staff’s positive and encouraging approach.

Family members spoke of their regular visits to see their relative at the home, which included outings to local parks or other local amenities, sometimes accompanied by staff. A family member told us. “The current cohort of staff is perfect; they provide person led care which is just right. There’s a proactive approach of getting people out and about.”

People appeared relaxed within their home and in the presence of staff. People were seen to be supported to choose activities of interest to them, which included day trips, visiting a local farm to help in the care of animals, trips to local parks and shops along with activities within the home, which included household chores, reading, puzzles, listening to music and watching television.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted in part due to concerns received about staff shortages and the high use of agency staff, and staff’s inability to meet people’s needs as staff did not have the skills they needed.

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

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.