Auden House Residential Home

We found the following examples of good practice.

The provider had created a safe and dedicated visiting room to allow residents to see and speak to their friends and relatives. The room had divider screen and external door. The room was well-ventilated and cleaned between visitors.

The provider was following best practice guidance in terms of ensuring visitors to the home did not spread COVID-19. Staff were adhering to personal protective equipment (PPE) guidance and practices, and there was a dedicated room for staff to change before and after their shift.

Communal areas were well spaced and residents had formed informal bubbles to maintain social distancing. Clear plans were in place for those who were required to self-isolate. For those residents who struggled with social distancing additional support was provided.

Auden House Residential Home is a residential care home providing accommodation and personal care to 24 people aged 65 and over at the time of the inspection. The service can support up to 24 people.

People’s experience of using this service and what we found

The registered manager and providers shared a clear vision and very strong values. They led by example and were passionately committed to providing exceptionally good quality individualised care and support.

They demonstrated a strong commitment to continuous improvement and took great pride from the home’s achievements. Their values and vision were at the centre of all developments. This ensured people were treated as individuals, were respected and were at the heart of the service provided.

Everyone was very positive about the registered manager and their exemplary approach to providing holistic support to people who used the service and staff who worked at the home.

Quality checks and audits enabled the registered manager to ensure improvements were embedded and excellent quality standards were maintained.

Activities were tailored to meet people’s individual needs, preferences and interests. They were designed to promote people’s well-being, prevent people becoming socially isolated and to keep people active.

Staff had a clear understanding of the importance of providing people with the opportunity to develop and maintain friendships and relationships. They had an exemplary approach to finding activities that were not just fun, but also helped people to develop confidence and friendships. Managers, the provider and all staff shared a passionate commitment to developing a sense of belonging and community

Care records identified what people wanted to achieve with the support and how staff could help this happen.

Staff were committed to ensuring people’s wishes at the end of their lives were respected and that people were able to die with dignity and amongst people who they knew and who knew them well.

People felt safe living at the home. Risks were well managed. Medicines were managed safely. Staff helped people to stay healthy and people had access to a range of health care professionals.

People were supported to have maximum choice and control of their lives. People were involved in decisions about their care. Policies and systems in the service supported this practice.

Staff received the training and support they needed to carry out their roles effectively. Staff had been safely recruited and there were enough staff to provide people with the person-centred support they needed.

The home was very clean, well decorated and furnished. People enjoyed the home cooked food.

The registered manager, provider and staff all knew people really well. Interactions were warm and friendly. Staff spoke with people in a respectful, kind and gentle way.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection -The last rating for this service was Good (published 20 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Auden House Residential Home on our website at www.cqc.org.uk.

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.

Auden House is a privately owned residential home in the Audenshaw area of Tameside, Greater Manchester which provides personal care and accommodation to older people. The home is located within close proximity of local shops and transport routes. Auden House is registered with the Care Quality Commission to provide care to a maximum of 24 people. At the time of the inspection 24 people were using the service.

The service had a registered manager in post. The 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.

The registered manager was not available at the time of the inspection. We were supported by the registered provider, deputy manager and administrator.

People and relatives felt the service was safe. One person said, “The security for a start makes you feel safe and knowing there’s always staff around if you need them.”

The provider had a recruitment policy in place and carried out relevant checks before staff started work. Staff received an induction when commencing employment.

Staffing levels were appropriate to people’s needs. The provider used a dependency tool to ascertain safe staffing levels. One relative told us, “There’s always staff around and the night staff are also very good as well.”

The provider had policies and procedures in place for medicine management. People's medicines were managed safely. We observed safe handling of medicines during the inspection.

Risk assessments were in place for people to mitigate assessed risks. These were reviewed and relevant to people’s needs. The provider carried out risk assessments on the building and kept a file of health and safety checks and certificates. Such as gas safety checks and electrical installation certificates.

Staff training was up to date. The provider ensured staff received appropriate training to meet the needs of the people using the service. The provider had an annual planner for staff supervisions and appraisal. Staff told us they received supervision on a regular basis and annual appraisals to review their performance.

Staff understood the principles of Mental Capacity Act 2005 (MCA) assessments and when they may be completed. Staff also had an understanding of Deprivation of Liberty Safeguards (DoLS) including what they were, when they were used and understood that a number of people living in Auden House had a DoLS in place.

Each person at the home had individual care plans which set out their specific needs and how they wanted to be supported. People and their families were involved in care plans; files contained a signed document to evidence involvement and agreement with plans. People’s care plans included risk assessments for pressure care, falls, personal safety, mobility and nutrition.

Records showed that people were supported to access healthcare professionals about their health needs, such as GPs, physiotherapists, chiropodists, opticians and dentists. We spoke with one visiting health care professional. They told us, “They had gotten the notes all ready for me, and knew what I was seeing the person for.”

Staff treated people with dignity and respect. We observed staff speaking to people in a respectful and polite manner, referring to people by their preferred name.

Information relating to various advocacy services including Independent Mental Capacity Advocates (IMCA) was available to people and displayed in the home with relevant contact details.

We observed the activities co-ordinator and other staff members engage people in a karaoke style sing along. We observed people engaging with staff and the activity, singing, smiling and dancing. One person told us, “[Activities co-ordinator] is lovely, they’re a breath of fresh air.”

The provider had a policy and procedure in place to manage complaints. No formal complaints had been received by the service. When asked if they had any complaints about the service one person said, “No not really. If there was anything serious I would complain.

The manager operated an open door policy in the home. Staff told us they felt the service was well managed. One staff member said, “She’s lovely. If you’ve got a problem she’ll sort it out for you.”

We received similar feedback from the people, relatives and health and social care professionals we spoke with. One person told us, “She’s fine, she always has a laugh and a joke with you. We obtained feedback from the local authority commissioning team who commented, ‘The council has a good working relationship with the manager of the home and they will respond to requests for information and seek advice if needed.’

Staff told us they had regular staff meetings. One staff member said, “We can bring things up in the staff meeting.” The provider is the dementia champion in the service; we found they held monthly dementia meetings to share best practice.

The registered manager and deputy manager completed a number of audits in the home which varied in frequency. These were effective in identifying issues and required improvements which were then acted upon.

Surveys were sent out to people, relatives and staff every six months. Results were recorded, analysed and actions were generated from feedback received. One of the most recent thank you cards received by the service stated, ‘Thank you very much for looking after [family member]. We were really happy with the warm welcome and you all do a brilliant job’.

The service were accredited for the Daisy Standards Award for dignity. The Daisy Standards are designed to foster an environment where Dignity in Care is at the forefront of everything that is done.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary, please read the full report.

This is a summary of what we found:

Is the service safe?

The visiting professional, relatives and people who lived at Auden house told us they had no concerns over the welfare of any of the people living there.

All care files contained a range of risk assessments, for example, skin integrity, bed rails and nutrition. We saw risk assessments were completed which helped to ensure peoples safety during day trips.

We saw evidence that arrangements were in place in relation to the recording of medicine and they were administered, stored and disposed of safely.

We saw there was enough skilled and experienced staff to meet the people's needs.

Is the service effective?

We saw evidence that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We asked people if they were asked about their preferences and wishes about how they wanted to spend their day. People told us the activities co-ordinators always asked them if they wanted to be included in the day's events.

We saw care plans were developed detailing the needs of the person, for example communication, mobility and memory. Staff had detailed what the person wanted to achieve and how they could help to assist the person in achieving these goals. We saw the culture of the home was a positive one and encouraged people to have quality of life.

Is the service caring?

The visiting professional that we spoke to told us 'All the people that I visit here are very happy with the care. The standard of care is excellent. I would place my own mother here'.

We saw the provider employed an activities coordinator during the week and had activities planned each day, for example, days out, exercises, games and quizzes. The activities co-ordinator told us how she planned activities to include people who had dementia. We saw a group of people living at the home had recently been on a canal boat trip. The relatives told us they thought this was a great idea. The two people who lived at Auden house that we spoke to told us this was 'Great fun' and 'Something different.'

Is the service responsive?

We saw all staff had undertaken dementia training in 2013 and had recently appointed a dementia champion in order to implement best practice and new ideas. We saw one of the most recent ideas was yellow signage around the home which is known best practice for people with dementia. The home was also implementing 'This is me' care plans which are detailed overviews of the person's preferences and social history. The activities co-ordinator told us how she planned activities to include people who had dementia.

We saw the home held monthly 'residents' meetings and staff meetings quarterly. We saw eight people attended the last residents meeting. They discussed the menu and ideas for activities.

Is the service well-led?

The manager told us they conducted medication audits and reviewed any health and safety incidences. They gave examples about how they implemented changes in order to make the service safer.

We asked people who lived at the home and staff about the manager and their ability to deal with concerns. They all felt the manager dealt with any issues very promptly and everyone we spoke with gave positive comments about their management style and personality for example, "She is always available", "Very nice and kind" and "Good manager".

On the day of our inspection there were 19 people who lived at Auden House. The people we spoke with told us they were happy living there and felt their care needs were met. Comments from people who used the service included; 'I like it. I can do things for myself but staff help me when I struggle. There's plenty to keep us occupied in terms of activities and the food is nice' and 'I'm happy here. I like the company. Staff help me with toileting and they give me tablets when I need them. Staff respond if I use the call bell'.

We looked at the measures in place to safeguard people from abuse and we found there were appropriate systems to enable this. Each person we spoke to told us they felt safe, secure and staff acted professionally around them.

We found new members of staff were recruited appropriately. This was done by ensuring two references from previous employers were sought and Criminal Records Bureau (CRB) checks undertaken.

We checked the suitability of the premises and found they were fit for purpose. There was disabled access at the rear of the building, a passenger lift and fire escape stairs which lead from the second floor.

We found there were appropriate systems in place to monitor the quality of service provision.

Some of the comments we received included :

"I like it here, it's flexible living arrangements and I can do what I want when I want."

"We have meetings where we can say what we feel and talk about any changes we might want."

"The staff are fantastic, they are kind and are always around to provided help and care."

We found that the staff team had a good knowledge of the people they provided care and support to and that they kept themselves up to date by reading care plans which meant they provided care and support to people in a safe way.

We saw that there were good systems in place to ensure that people received their medication as prescribed and that staff had received the necessary training to support them in this role.

During our visit we saw that the home was clean and tidy and that staff followed procedures to maintain a clean environment.

There were good procedures in place to support people to express their views and where appropriate make a complaint. We saw that complaints were managed sensitively and taken seriously no matter how small. We saw that where complaints were made these were fully investigated and satisfactory outcomes were achieved for the complainant.