We carried out an inspection of Alderwood on 8 and 16 March 2016. The first day of the inspection was unannounced. We last inspected Alderwood in May 2014 and found the service was meeting the relevant regulations in force at that time.Alderwood is a care home that provides accommodation and care for up to 32 people with nursing and personal care needs related to their mental health or dementia. The home is split into two units; one for rehabilitation, the other for assessments and short breaks. At the time of the inspection there were 19 people accommodated there.
The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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.
People told us they felt safe and were well cared for. Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe.
The building was safe and well maintained. The home was clean. Risks associated with the building and working practices were assessed and suitable steps taken to reduce the likelihood of harm occurring.
We observed staff act in a courteous, professional and safe manner when supporting people. At the time of our inspection, the levels of staff on duty were sufficient to safely meet people’s needs. New staff were subject to thorough recruitment checks. There was a low turnover of staff.
Medicines were managed safely for people and records completed correctly. People received the support they needed to manage medicines for themselves, so they were taken as prescribed.
As Alderwood is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the registered manager was familiar with the processes involved in the application for a DoLS. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests. Where necessary a DoLS had been applied for. Staff obtained people’s consent before providing care.
Staff had completed safety and care related training relevant to their role and the needs of people using the service. Further training was planned, including the use of psychological and physical interventions for people who displayed behaviour described as challenging. Staff were well supported by the registered manager.
Staff were aware of people’s nutritional needs and where people were at risk of dehydration or malnutrition appropriate support was provided. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly. People were provided with assistance to attend medical appointments.
Activities were offered within the home and people also accessed local community facilities and activities. Where able some people could leave the home independently. We observed staff interacting positively with people. We saw staff treated people with respect and explained clearly to us how people’s privacy, dignity and confidences were maintained. Staff understood the needs of people and we saw care plans and associated documentation was clear and person centred.
People using the service and staff spoke well of the registered manager and care provider and felt the service had good leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from external managers.