The Care Quality Commission
  • Care Home
  • Care home

Archived: Adderley House Residential

Overall: Requires improvement read more about inspection ratings

23 London Road, Long Sutton, Spalding, Lincolnshire, PE12 9EA (01406) 364918

Provided and run by:
Amber ARC Limited

Important: The provider of this service changed. See old profile

All Inspections

27 February 2015

During a routine inspection

We inspected Adderley House Residential on 27 February 2015. This was an unannounced inspection.

The last inspection took place on 12 August 2014 when we found that the provider was not meeting the standards of care we expected. Care was not planned or delivered to meet people’s needs or to ensure their welfare. People were not protected against the risks associated with infections and systems to prevent detect and control infections were not effective. The design and layout of the service was not always suitable and the premises were not maintained to an adequate standard. There were not always enough staff to meet people’s needs. The provider did not have effective systems to assess and monitor the quality of service people received and there were no effective systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service. After the inspection the provider wrote to us to say what they would do to meet the legal requirements. At this inspection we found the provider had made many improvements to the care people received and was meeting all of the legal requirements.

The home is registered to provide care for 40 people. The home has bedrooms for people in the main house and a number of self-contained flats. There were 23 people living at the home on the day of our visit, 10 in flats and 13 in the main home. The home was registered to look after older people.

There was a registered manager at the home. 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. However, they were due to retire shortly and a new manager had been appointed and was working alongside the registered manager.

The provider had completed a staffing analysis and used a recognised tool to ensure they had enough staff to meet people’s needs. As a result they had increased the number of housekeepers. However, at times staff were not deployed in areas where people needed assistance.

The provider used safe systems when new staff were recruited. All new staff completed thorough training before working in the home and had regular meetings with their supervisor to discuss their work. However, refresher training for staff had not been kept up to date. Staff were aware of their responsibility to protect people from harm. Staff knew how to raise any concerns they had about people’s safety to their supervisor or the registered manager. However, they were not all aware of how to raise concerns directly with external agencies.

The home was clean and tidy and the registered manager attended infection control meetings with the local council to ensure they kept up to date with new guidance. Staff knew how to work to reduce the risk of infection. While some equipment did not meet infection control standards this had been recognised by the new manager and action was planned to replace this equipment.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. The new manager was aware of their responsibilities under the MCA and there was no one at the home who was deprived of their liberty.

There were appropriate systems in place to obtain, store and dispose of medicines. Staff had received training in handling and administering medicines and did so competently. People and their families, had been included in planning and agreeing to the care provided. People had an individual plan, detailing the support they needed and how they wanted this to be provided. People were offered choices in the care they received and their choices were respected. There was a lack of activities at the home and people told us they would like more to do as they found it dull at times. People had also not been supported to access local community facilities such as the library.

The provider had completed a number of audits around the home and we saw they were successful at identifying concerns and issues. A quality survey had been completed, however, the provider had not reviewed the results to identify if any action was needed.

12 August 2014

During a routine inspection

When we visited Adderley House Residential there were 31 people living at the home. We spoke with three people who lived at the home and two relatives who were visiting. We reviewed three care plans and spoke with four members of staff and the deputy manager.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found-

Is the service safe?

The home had policies and procedure in place in relation to the Mental Capacity Act (MCA) (2005) and Deprivation of Liberty Safeguards (DoLS). The MCA states that every adult has the right to make his or her own decisions and must be assumed to have capacity to make them unless it is proved otherwise. The Deprivation of Liberty Safeguards are part of the MCA. They aim to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

The service was not clean or hygienic. We saw that people's rooms were not maintained to an adequate standard and the cleaning of commodes and mattresses did not protect people from the risk of infection. There was no cleaning schedule for areas other than the kitchen. This meant staff may not be aware of how often areas needed cleaning. We have asked the provider to tell us how they are going to meet the requirements of the law in relation to cleanliness and infection control.

We found the premises did not always support safe care. For example, the laundry facilities were not appropriate and there was no dedicated sluice area. However the provider had identified these and other areas for improvement and had included them on an annual improvement plan. We also saw that ongoing building work was going to be made safe, however, it was not going to be completed or removed in the foreseeable future. We have asked the provider to tell us how they are going to meet the requirements of the law in relation to the safety of the premises.

People using the service and staff told us there were not always enough staff to meet people's needs. Staff rotas showed 31% of shifts had not been staffed according to the staffing levels described to us by the manager. There was no formal or recorded system by means of which the provider reached a judgement about how many care workers were needed to keep people safe.

Is the service effective?

People's health and care needs had been assessed at admission. However, some of the care plans had not been regularly reviewed. Care plans were therefore not able to support staff consistently to meet people's needs. Issues with care planning had not been identified or rectified through the care plan audit process. We have asked the provider to tell us how they are going to meet the requirements of the law in relation to assessing and reviewing people's needs.

Is the service caring?

People we spoke with told us most of the staff were supportive. However, they all told us that some of the staff were not always as kind as they would like them to be. They told us this put the off ringing the bell for help at times. We have asked the provider to tell us how they are going to meet the requirements of the law in relation to ensuring staff have the correct skills for the job.

One person told us that all the staff used their given name. They told us they did not like the younger staff doing because they felt it was disrespected. They told us they would like the younger staff to address them more formally.

Is the service responsive?

People told us they knew how to make a complaint if they were unhappy. The service worked well with other providers. Records showed that people were supported to access appropriate health care when needed.

Is the service well-led?

The provider had not gathered the views of people about the quality of service they received. This meant the provider may not be aware of issues they needed to resolve.

The service had a quality assurance system; however records showed that it did not identify all of the shortfalls found during our inspection. When shortfalls were identified they were not always included on an action plan and so did not get resolved.

The system did not make sure staff were able to provide feedback to the registered manager, so their knowledge, skills and experiences were not being properly taken into account.

We have asked the provider to tell us how they are going to meet the requirements of the law in relation to monitoring the quality of service that people received and identifying, assessing and managing the risks to people's health, safety and welfare.