Applewood Care Home

Updated 16 January 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 5 January 2021 and was unannounced.

Updated 16 January 2021

This inspection took place on 24, 25 and 28 January 2019 and was unannounced.

Applewood is a 'care home'. People in care homes receive accommodation and nursing or personal care, as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Applewood Care home provides care for up to 39 older people living with differing stages of dementia. There were 37 people living at the home on the first day of our inspection, with one person receiving end of life care. All accommodation is provided in a two-storey building, within a rural village on the outskirts of Basingstoke.

At our last inspection in May 2016 we rated the service to be Outstanding. However, we were not provided with evidence to support the continued rating of Outstanding. At this inspection we found evidence to support the rating of Good.

Since our last inspection in May 2016 there had been a change of manager, which had had an adverse impact on staff retention and morale. The previous registered manager left the home in September 2018, shortly followed by a number of experienced care staff. The provider had been recruiting to fill these vacancies since. The new home manager had worked hard to rebuild staff morale and recruit new staff members. The home manager had almost completed the process to become the registered manager.

At this inspection we found the home was consistently well-managed by the home manager who provided clear and direct leadership. Staff consistently told us the management team had created a supportive environment where their opinions and views were discussed and taken seriously, which made them feel their contributions were valued.

Quality assurance systems monitored the quality of service being delivered, which were effectively operated by the management team, to drive continual improvement in the service.

The home manager collaborated effectively with key organisations and agencies to support care provision, service development and joined-up care, for example; local GPs and community mental health and nursing teams.

People experienced care that made them feel safe and were protected from avoidable harm and discrimination. When concerns had been raised, thorough investigations were carried out, in partnership with local safeguarding bodies.

Risks were assessed, monitored and managed effectively. Staff were aware of people’s individual risks and how to support them to remain safe.

There were sufficient staff to respond quickly and provide safe and effective care to people. The home manager operated a robust recruitment process, based on relevant pre-employment checks, which assessed the suitability of candidates to support older people and those living with dementia.

People's dignity and human rights were protected, whilst keeping them and others safe. Staff supported people who experienced behaviour which may challenge sensitively, in accordance with their positive behaviour support plans.

People received their prescribed medicines safely, from staff who had their competency to administer medicines assessed annually. People’s medicines management plans were reviewed regularly to ensure continued administration was still required to meet their needs.

High standards of cleanliness and hygiene were maintained throughout the home, which reduced the risk of infection. Staff followed the required standards of food safety and hygiene, when preparing, serving and handling food.

Staff had an effective induction, ongoing training and support to maintain necessary skills and knowledge to support people effectively.

People were supported to eat and drink enough to protect them from the risk of malnutrition and dehydration. Risks to people with more complex nutritional needs were promptly referred to relevant dietetic specialists.

Each person had an individual health action plan which detailed the completion of important monthly health checks. People were promptly referred to external services when required, which maintained their health.

The provider had continued to improve lighting, signage and decoration of the premises to support the needs of people living with dementia.

The management team had ensured people’s ability to make decisions was assessed in line with the Mental Capacity Act 2005 (MCA). People’s human rights were protected by staff who demonstrated a clear understanding of consent, mental capacity and Deprivation of Liberty Safeguards legislation and guidance.

Staff consistently treated people with compassion, kindness and respect. People were supported to follow their interests and hobbies which enriched their lives.

People’s choices and independence were promoted by staff supporting and encouraging them to do things themselves. Staff supported people to develop friendships within the home and maintain close links with their loved ones. This protected them from the risk of social isolation and loneliness.

People actively contributed to their care planning. Care plans were personalised and contained information such as the person’s life history, preferences and interests. People living with dementia had assessments relating to memory, mood, interactions and behavioural tendencies.

There were regular opportunities for people and staff to feedback any concerns at review meetings, staff meetings and supervision meetings. People and their relatives knew how to complain. The registered manager used concerns and complaints to drive improvement within the home.

People were supported with care and compassion at the end of their life to have a comfortable, dignified and pain-free death. Staff were thoughtful and consistently treated relatives with kindness, which made them feel involved, listened to, and informed, in the last days of their loved one’s life.