Adamscourt Residential Care Home

Adamscourt is a residential care home providing personal care to 16 older people. The service can support up to 25 people. Accommodation is over three floors and people have access to communal lounge and dining areas, specialist bathrooms and level access to a secure garden.

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

People were supported by trained staff that understood the actions needed to ensure people were not at risk of avoidable harm, abuse or poor care practices. Staff recruitment included safety checks such as employment references and criminal record checks to ensure they were suitable to work with older people. Staffing levels met peoples care and social needs. People had their medicines administered by trained staff who regularly had their competencies checked. Policies and practices in infection prevention and control were in line with government guidance.

Quality assurance processes were robust, multi-layered and effective in ensuring areas for improvement were identified and acted upon in a timely way. Staff felt appreciated and supported which empowered them to be involved in sharing ideas about the development of the service. People, their families and staff had opportunities to be engaged and involved in Adamscourt through meetings, video and telephone calls, emails and newsletters. The registered manager understood their legal duty in reporting a range of incidents to CQC and other statutory agencies. Relationships with other professional bodies such as Skills for Care ensured the service kept up to date with new guidance and best practices.

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 21 November 2019). 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

We carried out an unannounced comprehensive inspection of this service on 21 October 2019. Breaches of legal requirements were found. The provider 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 they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions ‘Safe’ and ‘Well-led’ which contain those requirements.

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 coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

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.

Adamscourt Residential Care Home is registered to accommodate up to 25 people. They specialise in the care of older people who are living with dementia. The service is split over three floors which were all accessible by stairs, a lift or a stair lift. There were 24 people living at the home at time of inspection.

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

People were not always protected from harm as risks were not always identified or reduced by management staff. Medicines were not always managed safely within the home.

There was a quality assurance and auditing process in place, but they were not always effective. Audits had not identified risk within the environment, medicines management and with recruitment processes.

People and their relatives told us staff were kind and caring and they were happy living at the home. Staff told us they were proud to work for Adamscourt Residential Care Home.

People had person centred care plans and access to a variety of activities. People knew how to make a complaint and were confident that the registered manager would deal with their concerns.

People had access to a varied diet and healthcare services as required. There were enough staff on duty, they received training and support to do their job.

The home involved people, relatives and staff in the service by holding meetings and sending questionnaires. The service worked well in partnership with others and continued to build community links.

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.

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

Rating at last inspection

The last rating for this service was good (published 18 May 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safe care and treatment of people, risk assessments and management oversight. 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.

Adamscourt Residential Care Home provides accommodation and personal care for up to 25 older people in a small homely environment. At the time of the inspection there were 21 people living there.

There was a registered manager at the home at the time of the inspection. 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.

There were systems in place make sure that the environment and way people were looked after were safe.

Staff had been trained in safeguarding adults and were knowledgeable in this field.

Risk assessments had been completed to make sure that care and support was delivered safely with action taken to minimise identified hazards.

Accidents and incidents were monitored to look for any trends where action could be taken to reduce likelihood of recurrence.

There were sufficient staff employed at the home to meet the needs of people accommodated.

There were recruitment systems in place to make sure that suitable, qualified staff were employed at the home.

Medicines were ordered, stored, administered and disposed of safely and overall there was good management of people’s medicines.

The staff team were both knowledgeable and well trained and there were induction systems in place for any new staff.

Staff were well-supported through supervision sessions with a line manager and an annual performance review.

Staff and the registered manager were aware of the requirements of the Mental Capacity Act 2005 and acted in people’s best interest where people lacked capacity to consent. The home was compliant with the Deprivation of Liberty Safeguards with appropriate referrals being made to the local authority.

People were provided with a good standard of food, appropriate to their needs. Action was taken in circumstances where people had lost weight.

Relatives, staff and people were positive about the standards of care provided at Adamscourt Residential Care Home. People were treated compassionately as individuals, with staff knowing people’s needs.

People’s care and support needs had been thoroughly assessed and care plans put in place to inform staff of how to care for people. The plans were person centred, covered people’s overall needs and were up to date and accurate.

A programme of activities was provided to keep people meaningfully occupied.

There were complaint systems in place and people were aware of how to make a complaint.

Should people need to transfer to another service, systems were in place to make sure that important information would be passed on.

The home was well-led. There was a very positive, open culture with good staff morale.

There were systems in place to audit and monitor the quality of service provided to people.