Alston Court Residential Home

Updated 19 February 2020

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.

Service and service type

Alston Court Residential Home (Alston Court) is a ‘care home’. People in care homes receive accommodation and 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 announced. We gave the service short notice of our inspection because we wanted the provider or the registered manager to be available to support the inspection. We also wanted to be sure people were at home to speak with us.

What we did before the inspection

Before the inspection we reviewed information we had received about the service. This information included ‘notifications’ the provider had sent to CQC. A notification is information about important events, which the service is required to send us by law. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send to give us some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made judgements in this report.

During the inspection

We spoke with four people who lived at the service and they told us in brief, about their life at Alston Court. Two people had gone out for the day before we arrived and did not return in time to meet with us. Because not everyone was able to tell us about the way they were looked after, we spent a period of time observing people, and the interactions they had with the staff team. We spoke with four members of staff and the registered manager. During our time at the home we were able to speak to one allied healthcare worker who was present. The day after our visit to the service we spoke with five families by telephone and received feedback from one other professional who was involved in the care of people. Comments have been included in the main body of the report. We looked at all 11 people's care records, staff training records, policies and procedures, complaints, audits and meeting notes.

Updated 19 February 2020

About the service

Alston Court Residential Home is registered to provide personal care for up to 11 people with a learning disability. This may include people who may be living with autism, dementia and physical disability. At the time of the inspection, 11 people were in residence.

The home is a adapted family home, located in the village of Kingkerswell and not far from the town centre of Newton Abbott. It was registered before the Registering the Right Support good practice guidance was issued. However, the service has been developed in line with the principles and values that underpin the guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with a learning disability and /or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them. The fact that Alston Court is larger than current best practice does not impact upon the care people receive.

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

People were safe. Staff received safeguarding training and understood their responsibility to keep people safe. They were familiar with the reporting process to be followed if any safeguarding issues were raised. Any risks to people’s health and welfare were well-managed. People were encouraged to be as independent as they were able, but plans were in place to mitigate risks so their independent activity was not compromised.

The number of staff on duty for each shift was sufficient to ensure each person’s care and support needs were met. Staffing levels also took account of planned activities and people’s needs when accessing the community. Pre-recruitment checks ensured new staff were employed safely. Checks included written references and a Disclosure and Barring Service check.

Medicines were well managed and administered by those staff who had been trained and were competent. People received their medicines as prescribed.

The assessment and care planning arrangements ensured each person’s care and support needs were met. Staff received the training they needed to be able to carry out their role well and were supported by the management team and the provider. New staff completed an induction training programme. People were supported to access the healthcare services they needed to maintain good health.

People received the food and drink they needed to maintain a healthy, balanced diet. Any preferences they had regarding food and drink were accommodated.

People were encouraged to retain as much choice and control of their daily lives and staff supported them in their best interests.

We have recommended that the management team and the provider increase their working knowledge of the Deprivation of Liberty Safeguards and the key requirements of the Mental Capacity

People were looked after by staff who were kind and friendly and listened to what they had to say. The staff team were fully committed to treating people who used the service as individuals. Each person received person-centred care and were included in making decisions, where possible about their daily life. Staff provided guidance to ensure safe decisions were made. The staff team were fully aware of each person’s specific needs. People looked well cared for.

The service delivered to each person was responsive to their specific needs. Each person was encouraged to be involved in the preparation of their care plan and having a say in how they wanted to be looked after. Plans were adjusted as and when needed so new care needs were accounted for, or in recognition that people wanted to be looked after in a different way. The service would endeavour to continue looking after people who became very ill or had end of life care needs and had started to work with people about any end of life wishes. They achieved this working in conjunction with family and healthcare professionals.

People were supported to be as active as possible and do the social activities they liked. People were able go out independently, or with staff support.

The service was well led. The registered manager and deputy had both worked at the service for many years and provided good leadership for the staff team. People were very much at the centre of all decision making. Their views and opinions were listened to and acted upon. The providers were both actively involved in the running of the service.

We have recommended that the provider implement a formal and recorded quality assurance system. This would ensure any shortfalls were identified and actions then taken to make the improvements required.

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 20 July 2017).

Why we inspected

This was a planned inspection based upon 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.