Alder House Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safety risks to people were managed well. Managers assessed and reviewed safety risks to people and made sure people, and those important to them, were involved in making decisions about how they wished to be supported to stay safe. There were enough staff to support people with their needs. Managers reviewed staffing levels regularly to make sure there were always enough suitably skilled and experienced staff on duty. Staff received relevant training to meet the range of people’s needs at the service. Staff received support through supervision and appraisal to support their continuous learning and improve their working practice. Managers made sure recruitment checks were undertaken on all staff to ensure only those individuals that were deemed suitable and fit would be employed to support people at the service. People’s medicines were well managed. The home was clean and tidy and people were protected from the risk of the spread of infection.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and relatives told us they were involved with care planning and were aware of the risks relating to their care. A relative told us they and their family member were involved with agreeing the care plan and how care was to be provided. They said, “An initial assessment was carried out and a care plan formulated when [my family member] first went to Alder House for respite. This has been updated (at my family member’s request) with additional help.” Another relative said, “[My family member] had a terrible fall at home and needed care. We went to 3 different places before we decided which service. We knew this was the one to come to. We then discussed what care was needed and it has been implemented perfectly.” This relative’s family member told us they were always involved with decisions about the risks to their health and how they wanted care to be provided.

Staff felt able to provide care in accordance with people’s wishes but also by supporting them to take risks should they wish to. This included people moving around the home with minimal or no support from staff. The registered manager was aware of the importance of providing staff with sufficient information and guidance to support people in their preferred way that did not place unnecessary restrictions on their freedoms and right to choose.

Care plans and risk assessments contained essential information for staff to be able to provide safe care and support. The risks to people’s care and support needs and their health and safety had been assessed and robust care plans put in place to guide and inform staff on how to care for people. Where able, the risks to people’s health and safety and the subsequent care required to keep them safe had been discussed with the person and/or an appropriate person such as a relative. Care plans were in place for high risk areas such as personal care, falls and medicines. Any actions needed by staff to reduce the risk had been recorded. Environmental risks had been discussed with people and recorded within their care records. Agreements on how to make a person safe in an emergency had been agreed and recorded. This helped to keep the person safe.

We observed people being encouraged to do things for themselves such as walking around the home with a walking aid, moving from chair to chair with staff supporting people where needed. We observed 2 staff helping a person who was able to communicate their wishes. The person was able to stand but unable to walk forward. The staff communicated well with the person and offered reassurance. The person was still unable to walk forward so they asked if they would like to stay where they were or to use a walk aid. The person decided to stay where they were. We saw other similar interactions between staff and people where risks were explained, and staff respected people’s wishes. People were not rushed and given time to make a decision.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff responded quickly when people needed them. Call bells were responded to within minutes meaning people were not left waiting for long periods of time. Staff were visible throughout the home in communal areas; they visited people in their bedrooms and there was a calm atmosphere throughout. Staff knew people well. They understood people’s needs and people responded well to them. Staff contributed to a ‘homely’ feel at this home.

Most people and relatives told us they felt there were enough staff in place to provide safe care. A small number said they felt more staff were needed at weekends. People and relatives felt staff were well-trained, experienced, and understood how to provide safe care that met their or their family member’s individual needs. A relative said, “I think the staff do a really good job in caring for my relative who is very deep into dementia and is not always easy to handle.”

Staff felt there were enough staff in place to provide safe care. Staff felt well-trained, and they told us they received regular supervision of their role. A staff member said, “We do have enough staff on duty - we do have busy days and get a bit overwhelmed but in general staffing is fine.” The registered manager told us they felt they had sufficient numbers of staff to manage the service effectively and to provide high quality, safe care for people.

The provider had processes in place that ensured there were enough well-trained, experienced, and suitable staff to provide safe care for people. Staff training requirements were monitored, and any gaps or training needs addressed quickly. The provider’s policy stated staff were required to receive at least 5 supervisions and an appraisal in the calendar year. Records showed the provider was on track to meet this requirement. This will ensure people continued to receive care from well-trained and competent staff. The provider’s dependency assessment calculated how many staff were needed to provide people with the care they needed safely and effectively. Records showed there were consistently more staff in place than the calculated minimum to meet people’s needs, helping to provide people with safe care. Staff were recruited safely. Checks on staff identification, right to work, past employment and criminal records were completed before people commenced their role. All inexperienced staff shadowed an experienced member of staff until they were deemed competent to conduct their role alone. These processes helped to ensure people received safe care from competent and suitable staff.

The provider had ensured there was an effective approach to assessing and managing the risk of the spread of infection. This was in line with current relevant national guidance. There were clear roles and responsibilities around infection prevention and control. All staff were made aware of what was required of them to keep the home clean and tidy. The domestic staff were monitored by robust infection control audits. This helped to keep people safe from the risk of the spread of infection.

People received care and support in a clean and tidy home that reduced the risks to their health and safety from the spread of infection. People and relatives told us they felt the home was clean and tidy. A person said, “My room is a good size and is nice and clean.” A relative said, “I specifically chose Alder House because it is always clean and tidy. I have been in other care homes that smell. Alder House definitely doesn't!” Another relative said, “The home is kept clean and tidy, and the home environment feels safe and happy.”

The home was clean and tidy throughout. This included people’s bedrooms which were well-maintained and free from malodour. We observed staff followed safe infection control protocols, using PPE when needed, changing it before providing care to a different person and disposing of it safely. The housekeeper and domestic staff had access to a multitude of cleaning products that aided them in keeping the home clean, tidy and with a pleasant smell.

Staff felt the home was clean and tidy. Care staff supported domestic staff in keeping the home clean and tidy. They told us personal protective equipment (PPE) was available when needed. Domestic staff felt they had sufficient time and equipment to keep the home clean. The registered manager was proud of the cleanliness of the home. Staff had clear roles and responsibilities in keeping the home clean. They told us they checked the cleanliness each day and raised any concerns during meetings with domestic staff.

The provider had ensured effective processes were in place that enabled the safe management of medicines. Safe storage processes were in place, this included the storage of controlled medicines. People’s medicine administration records and care plans were well-completed, they included people’s allergies, details of medicines to be administered on ‘as needed’ basis and what dosage they required. An electronic monitoring system was in place that prevented staff giving a person too high a dose of their medicines. All of these processes helped to keep people safe from the risks associated with medicines.

We spoke with a senior care worker who administered medicines. They spoke confidently about how they ensured safe medicines management. They were able to explain how they managed controlled drugs and what they would do if there was a medicines error. The registered manager was confident medicines were managed safely in the home. When we raised a minor issue on the day of the assessment they took immediate action.

People and relatives were happy with the way their or their family member’s medicines were managed and were appropriately involved in decisions about their medicines. The risk of people experiencing harm was reduced due to safe medicines practices. A relative said, “[My family member] struggles to swallow medicines and they [staff] have managed to change all medicines to liquid form. They didn’t have to do that, and it has been a major relief. It has made a major difference to [my family member’s] health.” Other relatives told us they had seen staff administer medicines in communal areas and they had never had any concerns about the way this had been carried out.