Archived: Alde House

Updated 20 September 2019

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.

Inspection team

The inspection was carried out by one inspector on 6 and 7 August 2019.

Service and service type

Alde House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We looked at information we held about the service and what people had told us. We contacted local authority safeguarding teams. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager and three staff which included the head of care. We spoke with three people and two relatives. We reviewed three people’s care records in detail. We looked at three staff recruitment and training records. We read incident and accident records. 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 received feedback from four relatives and received feedback from three members of staff.

Updated 20 September 2019

About the service

Alde House is a residential care home providing personal care up to 17 older adults. At the time of the inspection 16 people lived at the home. The care home is located within the Chiltern area of outstanding natural beauty. People had access to a lounge, dining area, sun lounge and could freely access a garden area.

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

The service did not routinely ensure all the required pre-employment checks were completed for new staff. People were supported by enough staff who were deployed to meet their needs. Staff were skilled in recognising potential abuse and knew what to do to protect people from harm.

People were not routinely supported to have maximum choice and control of their lives and staff did not routinely support them in the least restrictive way possible and in their best interests. This was because the service did not fully adopt best practice for assessing people’s mental capacity to make informed decisions.

People, relatives and staff told us the service was well-led. We found the provider and registered manager failed to notify us of all reportable events. Record management within the service required improvement.

We observed people were supported by staff who demonstrated kindness and a caring approach. People were treated with dignity and respect by staff. People and their relatives described the care home as ‘Homely’ and felt part of a ‘Family’.

People told us they received a personalised service from staff and were supported to engage in meaningful activities. People were supported to practise their chosen faith.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 15 August 2018).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvement had been made. However, we found the provider was still in breach of regulations.

This is the second consecutive time the service has been rated requires improvement.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led section of this full report.

Enforcement

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We identified one breach of the Care Quality Commission (Regulation) Regulations 2009.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.