We carried out a review of the data available to us about Aldingbourne Cottage on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Aldingbourne Cottage, you can give feedback on this service.
We found the following examples of good practice
Staff and people completed individual risk assessments for visitors together. The risk assessments were completed before every visit to the service by a relative or friend.
The registered manager had moved into the service when temporary agency staff were being used due to permanent staff having to shield away from the service. The registered manager told us that this management oversight and support had meant people were cared for safely and infection control practices were maintained.
Garden parties and BBQs were held throughout the summer and staff were re-deployed to support with extra activities to occupy people during the day. This was as people were not able to attend their day centre due to restrictions.
Aldingbourne Cottage is a residential care home providing personal care and accommodation for people with a learning disability or autism. At the time of our inspection the service was supporting 10 people.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by staff practices and the focus on supporting people to live as full a life as possible. People using the service receive planned and co-ordinated person-centred support that is appropriate to their needs. A relative told us, “I feel that [My relative] is now part of a community rather than living in a lonely situation with the unrealistic expectation that [they] could become more independent.”
The service was generally maintained to and acceptable standard. However, outside a person’s bedroom the carpet was damaged and could represent a trip hazard. We also found that the service bathrooms were in need of redecoration and that the wet room smelt musty and damp. Following feedback at the end of the inspection immediate action was taken to address these issues. The carpet was replaced, bathrooms redecorated and works to replace the wet-room were scheduled for December 2019.
Staff and managers had some understanding of the Mental Capacity Act and had made necessary and appropriate applications to the local authority of the authorisation of restrictive care plans under the Deprivation of Liberty safeguards. However, there as limited evidence available of best interest decision making. This issue had been identified by the manager prior to the inspection. We have recommended the service reviews its current practices to ensure best practice guidance is followed.
The service’s recruitment practices were safe and there were enough staff on duty to meet people’ support needs. Medicines were managed safely and there were systems in place to help people to manage their finances.
Staff had received safeguarding training and understood how to protect people from all forms of abuse or discrimination. Risks were appropriately managed, and staff knew how to support people if they became anxious or upset.
Staff had the skills necessary to meet people’s need and their training was regularly refreshed. Staff told us there were well supported by the registered manger and records showed they received regular supervision.
The staff team provided support with kindness, care and compassion. People told us, “The staff are good” and “The staff are very nice here, they look after me quite all right.” While relative said, “The staff in the team seem to be very caring and friendly” and professionals’ comments included, “The staff seem on the ball and friendly. People seem happy.”
People’s care plans were accurate and detailed. They provided staff with enough guidance to enable them to meet people’s needs. People and their relatives were involved in the development and review of care plans and told us these documents were accurate. Staff had a good understanding of people’s individual communication preferences and specific, picture based, tools had been developed to support peoples’ decision making.
People and relatives knew how to raise complaints and systems were in place to ensure any complaint received was fully investigated and resolved. Feedback was valued, and regular surveys were conducted to ensure the service was meeting people’s expectations.
The service was led effectively by the registered manager and the staff team were well motivated and focused on providing person centred support. Quality assurance systems were effective and designed to drive improvements in the service’s performance.
Rating at the last inspection
At our previous inspection the service was rated Good. (Published 14 June 2017)
Why we inspected
This was a planned initial inspection of the service.
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.
The service had two registered manager’s in post However the person who supported us during this inspection was responsible for the day to day management of the home and therefore we have referred this person as 'the registered manager throughout this report. A registered manager is a person who has registered with the Care Quality Commission (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 and associated Regulations about how the service is run.
People felt safe with the home’s staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm. Risks to people’s safety had been assessed and care records contained risk assessments to manage identified risks.
People were supported to take their medicines as directed by their GP. Records showed that there were appropriate arrangements for obtaining, storing and disposing of medicines.
Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely and our observations also confirmed this.
Food at the home was good. There was a four week rolling menu displayed in the kitchen. People had regular meetings where they had an opportunity to discuss and plan menus. Staff provided support to people to help ensure meals were balanced and encouraged healthy choices
Staff were aware of people’s health needs and knew how to respond if they observed a change in their well-being. Staff were kept up to date about people in their care by attending regular handover meetings at the beginning of each shift. The home was well supported by a range of health professionals.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made and how to submit one. The provider had suitable arrangements in place to establish, and act in accordance with the Mental Capacity Act 2005 (MCA). Staff had an understanding of the MCA.
Each person had a care plan which informed staff of the support people needed. Staff received training to help them meet people’s needs. Staff received an induction and there was regular supervision including monitoring of staff performance. Staff were supported to develop their skills by means of additional training such as the National Vocational Qualification (NVQ) or care diplomas. These are work based awards that are achieved through assessment and training. To achieve these awards candidates must prove that they have the ability to carry out their job to the required standard. All staff completed an induction before working unsupervised. People said they were well supported and relatives said staff were knowledgeable about their family member’s care needs.
People’s privacy and dignity was respected. Staff had a caring attitude towards people. We observed staff smiling and laughing with people and offering support as required. Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and these were communicated to staff in a variety of ways – verbally, through physical gestures or body language. People were involved in decisions about their care as much as they were able. Their privacy and dignity were respected and promoted. Staff understood how to care for people in a sensitive way.
The registered manager’s operated an open door policy and welcomed feedback on any aspect of the service. There was a stable staff team who said that communication in the home was good and they always felt able to make suggestions. They confirmed management was open and approachable.
There was a clear complaints policy and people knew how to make a complaint if necessary.
The provider had a policy and procedure for quality assurance and the registered manager told us that they and the deputy manager worked alongside staff and this enabled them to monitor staff performance.
Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered managers and provider to monitor if people’s needs were being met.