Aldyn Care Home

Aldyn Care Home is a residential care home providing care, rehabilitation and support for up to 12 people living with mental health needs. At the time of the inspection, 10 people were living at the home. The home is two properties joined together with communal lounges, bathrooms and a kitchen.

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

Recruitment procedures were not always robust to ensure staff were of good character before they started working at the service. This is an area of practice that needed improvement.

Staffing levels met people’s needs. Medicines were managed safely for people. Risks to people were identified, assessed and reduced. Staff had a positive approach to managing risk. The home was clean and hygienic.

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 had good access to health services when required. People’s nutritional needs were known and met. Staff received training to effectively support people living with mental health conditions.

People received support from staff who were kind and caring. One person told us, “We’re like a family really. I think the staff are very good. Always helpful.” People’s dignity was maintained and respected and their independence promoted. People’s communication needs were supported so their views on their support were understood.

People had access to activities that met their interests and they were active in their local community. Staff knew people well and encouraged them to develop their skills. There was a complaints procedure in place which was known by people.

The home was well-led. People and staff spoke positively of the management of the home. There was a friendly and calm atmosphere in the home, Staff told us they felt supported. Quality assurance processes drove improvement to the support people received. The registered manager and staff team were committed to continuous learning.

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 30 May 2018) and there were multiple breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Aldyn Care Home is a residential home providing care, rehabilitation and support for up to 12 people with mental health needs. At the time of the inspection, 11 people were living at the service. Some people might be detained under the Mental Health Act and may be under supervision in the community.

At the last inspection, the service was rated Requires Improvement.

At this inspection we found the service remained Requires Improvement.

Why the service is rated Requires Improvement.

The service had a registered manager in post. This person was also the registered provider. 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.

The previous inspection in January 2017 found concerns that staff had not received training to keep people safe and systems were not robust to safeguard people. The previous inspection also identified staff had not received mental health training and regular supervision. The provider sent us an action plan following this inspection. We found these areas had improved, however we found concerns in other areas at this inspection.

Staff knew people well and knew their risks but risk assessments and care plans did not accurately reflect people’s current risks or have sufficient detail to guide staff on what action they should take to keep people safe. We also found one accessible upstairs window at the service posed a potential risk if people wished to self-harm.

Staffing levels were adequate to support people who were largely independent and required emotional support. However, the staff duty rota was not an accurate reflection of the staff on duty at the time of the inspection.

People were not always supported by staff that confidently made use of their knowledge of the Mental Capacity Act (2005), to make sure people were involved in decisions about their care and their human and legal rights were respected. The service did not always follow the processes which were in place to protect people’s human rights and liberty.

There were some quality assurance systems in place but these required improving. The management team were not up to date with current mental health policy and practice. People’s opportunities for recovery were limited by this. Inspection feedback was listened to and the registered manager and deputy keen to make changes and improvements to enhance care.

Staff responded quickly when they noted changes to people’s mental or physical well-being, contacting the appropriate health professionals, for example people’s named mental health nurses. People or where appropriate those who mattered to them, were involved in discussing people’s care needs and how they would like to be supported. People’s preferences for care and treatment were identified and respected.

Staff exhibited a kind and compassionate attitude towards people. Positive, caring relationships had been developed but aspects of people’s care was not always person focused. Staff had appreciation of how to respect people’s individual needs around their privacy and dignity.

People had their medicines managed safely. People received their medicines as prescribed, received them on time and understood what they were for. People were supported to maintain good health through regular access to health and social care professionals, such as GPs, mental health nurses and social workers.

People told us they felt safe. The environment was uncluttered and clear for people to move freely around the home. Most staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm.

People were supported by a staff team that had received a comprehensive induction programme, training for mental health conditions and ongoing support from the registered manager and deputy manager.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.

The service had a policy and procedure in place for dealing with any concerns or complaints.

No written complaints had been made to the service in the past twelve months.

People and described the management to be supportive and approachable. Staff talked positively about their jobs. The deputy manager was supported by the registered manager / provider. Both were visible at the service and well known.

We found three breaches of our regulations.

You can see what action we told the provider to take at the back of the full version of the report.

The provider was also the 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 spoke highly of the care provided at Aldyn Care Home and told us they felt safe living there. However, we found some areas of practice that required improvement. Staff were not all clear about how to protect people from harm or abuse. Some staff had not received training in safeguarding and could not tell us how they would recognise signs of abuse.

Staff were not receiving supervision and appraisals consistently to ensure they were competent, and to support their professional development. This meant that the registered manager could not be assured that staff had the skills, knowledge and support they needed to be effective in their role.

Risks to people were identified and assessed and some care plans contained clear guidance for staff in how to manage the risks. However, this approach was not consistent and staff did not always have the guidance they needed to care for people safely.

Incidents and accidents were recorded and actions were taken to prevent further occurrences.

People’s medicines were managed safely and there were enough staff on duty to care for people and meet their needs.

People told us they enjoyed the food at Aldyn Care Home and that they had enough to eat and drink. People were able to choose what to eat and their preferences were respected. One person said, “It’s good home cooking.” Another person told us, “There’s a good choice, if you don’t like what’s on the menu you can ask for something else.”

People were supported to have access to a range of health care services. One person said, “I have to see the nurse regularly, staff remind me and support me if I need it.” Staff had developed strong links with local health care services. People’s consent to care and treatment was sought in line with legislation and staff understood their responsibilities in regard to the Mental Capacity Act (2005).

People had developed positive relationships with staff and spoke of their caring nature. One person said, “They really couldn’t be kinder.” Staff knew the people they were caring for well and spoke of them with compassion and respect. People told us they were happy with the care and felt that staff cared about them. People’s personal information was kept securely and staff understood the importance of maintaining confidentiality.

People were receiving personalised care that was responsive to their needs. A staff member said, “We pick up on changes, sometimes even quite small things, because we know people well.” People were supported to maintain the relationships that were important to them and to be as independent as possible. There was a complaints procedure in place and people knew how to raise a complaint if they needed to. One person said, “I did have to make a complaint once and staff sorted it.”

Staff and people spoke highly of the management of the home and said that the registered manager was friendly and approachable. One person said, “The place is well run and very efficient.” Staff demonstrated a clear understanding of the vision and values of the home and this was embedded within their practice. People and staff spoke about the positive, homely atmosphere. There were systems and processes in place to provide management with oversight and assurance that good standards of care were being maintained. People said that their views were regular sought on the home.

We found two breaches of regulations. You can see what action we told the provider to take at the back of the full version of the report.

As part of the inspection we spoke with four people who used the service. The care staff we spoke to were, one team leader, one senior support worker and two support workers.The registered manager was on leave. We also reviewed records relating to the management of the home which included care plans, daily care records, staff records, staff rota's and audits.

Is the service safe?

People told us they felt safe. Systems were in place to make sure that the manager and staff learned from events such as accidents and incidents, complaints and concerns. We saw evidence of a recent incident which had been recorded, evaluated and acted upon to reduce the likelihood of a recurrence.

The service was safe, clean and hygienic. There was evidence of major refurbishment and re-decoration to the home. Tradesmen had an area to work from and this was locked in their absence.

The registered manager set the staff rotas, and took into account people's care needs when making decisions about the numbers, qualifications, skills and experience required. Staff shortfalls were met by the regular home staff doing overtime.This helped to ensure that people's needs were always met and that care was delivered by appropriately trained and skilled staff.

Is the service effective?

We saw people's daily diaries which detailed their appointments with health care professionals. We saw that the home liaised frequently with the community mental health team. People's health and care needs were assessed with them, and they were involved in writing their plans of care. People said that they had been involved in writing them and they reflected their current needs.

Is the service caring?

People were treated with respect and dignity by the staff.

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. We saw staff engaged in activities with people. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. People knew how to make a complaint or compliment if they wished. There had been no recent documented complaints.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records we saw showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

We saw procedures for making comments or complaints in a prominent place in the home. People told us they felt listened to, were involved in meetings and knew how to make a complaint or comment.

Staff told us they were clear about their roles and responsibilities and had regular meetings and appraisals with their line manager. This identified training needs and career development and helped to ensure that people received a good quality service at all times by staff who were up to date with current practices.

People who use the service understood the care and treatment choices available to them. People expressed their views and were involved in making decisions about their care and treatment. People told us that staff explained things to them. People were free to spend their time how they wished. One person told us "I like to spend time reading in my room". Another told us "I have sat out in the sun with the staff".

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were supported to attend health appointments in the community.

We saw that systems were in place to prevent people suffering abuse.

People were cared for by a staff that had been trained to offer care and support to the correct level.

There was a complaints policy and procedure in place. Complaints were recorded as were compliments. We saw one comment which said 'We are so grateful to you at Aldyn. (Our relative) is very happy with life there". There had not been any complaints since the last inspection.