The inspection took place on 22 February 2018 and was unannounced.Alderwood is a care home. People in care homes receive accommodation and nursing or 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. Alderwood Care Home is registered to provide accommodation and personal care with nursing for up to 65 older people who may also have dementia. Care is provided on three floors, residential, people living with dementia and people who have nursing needs. At the time of our inspection 65 people were living in the service.
At the last inspection in 2016, the service was rated Good. At this inspection, we found the service had continued to develop and was therefore rated outstanding.
The service had a registered manager in post. 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.
We found the service was very well managed. The service had a full complement of nurses with the necessary skills to meet the needs of the people using the service. This meant people received continuity of care from highly skilled staff. There was an established management team who regularly supported and audited the service to ensure it provided high quality care.
Staff were extremely motivated in their role and valued their focus was on the people that used the service. The manager was enthusiastic and motivated. They were visible and actively involved in supporting people and staff. Staff morale was extremely high and they felt listened to and that their views were valued.
The provider worked extremely hard with the management team to ensure all staff felt valued and appreciated.
Staff had excellent relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times. S
People were encouraged to follow their interests and hobbies and to engage in meaningful person centred activities. People were kept stimulated and engaged and the providers helped ensure that people continued to live a full a life as possible and to have their wishes fulfilled. They were supported to keep in contact with their family and friends. The service worked extremely hard with relatives and friends to ensure everyone was supported at all times. People’s care plans were individual and contained information about people’s needs, likes and dislikes and their ability to make decisions.
The service was brightly decorated and stimulating for the people living there. The communal areas were decorated to a high standard were clean and furnished giving an overall homely feel. The outside area had accessible gardens with benches and easy access for people with limited mobility.
People were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. Medicines were managed safely by staff that had been trained and assessed as competent to administer medicines and there were sufficient numbers of care staff with the correct skills and knowledge to safely meet people’s needs.
The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act.
People had sufficient amounts to eat and drink to ensure their dietary nutritional needs were met. The service worked very well with other professionals to ensure that people’s health needs were met. People’s care records showed that, where appropriate, support and guidance was sought from healthcare professionals.
People received support that was personalised and tailored to their needs. They were aware of how to complain and there were a number of opportunities available for people to give their feedback about the service.
The management team had systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required. The service took into account people's feedback and was continuously trying to improve the service and provided an inclusive service.