Adelaide House Residential Care Home

Updated 26 October 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 Health and Social Care Act 2008.

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

The inspection team consisted of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Adelaide House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Adelaide House Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we received about the service since the last inspection and sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with seven staff including the registered manager, provider, care staff, housekeeper and cook. We spoke with two people, six relatives and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked at five people’s care plans, a variety of medicine administration records, recruitment files and records relating to the management and governance of the service.

Updated 26 October 2022

About the service

Adelaide House Residential Care Home is a residential home providing personal care for up to 23 people in one adapted building. Some people who live at Adelaide House have dementia or a cognitive impairment. At the time of our inspection there were 18 people using the service.

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

Risks to people’s health and safety were assessed and improvements had been made to risk management plans. However, some care plans contained incorrect information. We found improvements had been made to medicines practice and record keeping. However, further improvements were needed to ensure these were administered as prescribed and stored safely. The registered manager took action in response to safeguarding concerns and updated people’s care plans as necessary.

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. However, some people assessed as lacking capacity to make decisions about their care and treatment had also signed their consent to certain aspects of their care and treatment, rather than being signed in their best interests, by a person legally authorised to do so.

Audits of care practice and systems to monitor the safety of the premises and environment were in place. However, further improvements were needed to ensure these provided robust oversight and scrutiny of care practice standards. There continued to be no formal system to gather the views of people and relatives regarding their experiences of care and whether they had suggestions for improvements. However, we continued to receive positive feedback from relatives regarding Adelaide House and that management were visible and approachable.

Staff were trained in safeguarding and understood their responsibilities to report potential safeguarding concerns. There were enough staff to ensure people’s needs were met safely and in a timely way. Feedback from people and staff confirmed this. We were assured by the provider’s infection, prevention and control practices. Visiting to the care home aligned with government guidance.

New staff received an induction and completed the Care Certificate. The registered manager worked with trusted assessors and social workers to ensure any admissions from hospital or the community could be supported safely. Staff understood people’s individual dietary needs and prompted people to eat and drink more, when needed. People were able to access health professionals and medical treatment when needed. The provider adapted the design and decoration of the building to meet people’s mobility and social needs.

Important events and incidents were notified to CQC, and the latest CQC rating was displayed in the home as per regulatory requirements. The provider worked with external health and social care professionals to ensure people had access to services they needed, in response to changes in their health and to improve their health outcomes.

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 August 2021) and there were two breaches of regulations. 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 the provider remained in breach of regulations.

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

You can see what action we have asked the provider to take at the end of this full report.

Why we inspected

We carried out an unannounced focused inspection on 6 July 2021. Breaches of legal requirements were found. The provider was issued with a Warning Notice and completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met, that they had followed their action plan and to confirm they now met legal requirements. The overall rating for the service has not changed and remains requires improvement. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Adelaide House Residential Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to good governance at this inspection.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.