Care service description

Alandale Residential Home is a residential care home for 35 older people. The service is a purpose built residential home. Accommodation is arranged over two floors and there is a lift to assist people to get to the upper floor. The service has 35 single bedrooms. There were 34 people living at the service at the time of our inspection.

Rating at last inspection

At the last inspection in September, the service was rated Good.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

The registered manager was leading the service and was supported by a deputy manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager had not informed CQC of two significant events that had happened at the service, so we could check that appropriate action had been taken. Action had been taken to keep the people safe following the incidents. The registered manager sent us the notifications following our inspection. The provider and registered manager took action to make sure notifications were sent without delay in the future. The registered manager had quickly notified us of other notifiable events.

Staff were kind and caring to people and treated them with dignity and respect at all times. Everyone we spoke with told us people and staff were like a large family. One person’s relative said, “They [staff] are truly some of the kindest, most caring people I have ever met. They always go that extra bit for the residents here, nothing is too much trouble. They treat every one of them like they would their own family”.

Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager. People were not discriminated against and received care tailored to them. Their comments included “I am always made to feel I count as a person and an individual here” and “It is nice to feel so comfortable and at home here, I am safe, cared for and really very happy living here”. Complaints were investigated and responded to. People had enough to do during the day, including taking part in activities they had enjoyed.

Assessments of people’s needs and any risks had been completed and care had been planned with people and their relatives to meet their needs and preferences and keep them safe. One person said, “I don’t have to worry about anything, I am so well cared for”.

Changes in people’s health were identified quickly and staff contacted people’s health care professionals for support. People’s medicines were managed safely and people received their medicines in the ways their healthcare professional had prescribed. People were offered a balanced diet and food they liked.

The requirements of the Mental Capacity Act 2005 (MCA) had been met. The registered manager knew when assessments of people’s capacity to make decisions were needed. Staff assumed people had capacity and respected the decisions they made. When people needed help to make a particular decision staff helped them. Decisions were made in people’s best interests with people who knew them well.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS applications had been made people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were enough staff to provide the care and support people needed when they wanted it. One person told us, “However busy the staff are they are never t

On 13th December 2013 we carried out an inspection at the service and found that essential standards were not being met in relation to the lack of accurate records.

During our inspection the areas where we had concerns had been addressed and improved. Also people had the opportunity to engage in a variety of social activities which were of their choosing. People told us that they had recently had a trip out to a local vineyard for afternoon tea. The overall consensus was that it had been a very enjoyable outing and that they were looking forward to the next one. One of the people who used the service told us that they often went out shopping and to the hairdressers. Another person commented “If I want to go anywhere I just ask and the staff take me.”

We looked at plans of care which had been updated and were now in much more detail.

We made an unannounced inspection to the service and spoke with people who use the service, staff members and the owner.

We met and spoke with some of the people who use the service and everyone we spoke with expressed that they were very happy living at Alandale. We observed interactions between the people and the staff and also people’s reactions to the staff. We observed how people reacted and responded to see if they were happy, bored, discontented, angry or sad. We saw that staff engaged with people in a warm and positive way and offered support when they needed it.

People told us that they had the care and support they needed to remain well and healthy. One person said, “I am very well looked after here”. Another person commented, “I would like to go out once in a while but unless you have family to take you out you are stuck”.

People said that they were involved with the planning of their care. One person told us, “Staff talked through my care plan with me”. We found that some risk assessments did not show an effective way of minimising risk.

People's health and welfare needs were being met by competent staff.

People told us that they felt safe at Alandale and that if they had any concerns they would speak to staff. One person commented, "I feel very safe here. The food is good and the staff are very helpful".

People who use services said that the staff treated them with respect, listened to them and supported them to raise any concerns they had. They said that they received the health and personal care they needed and that they were comfortable in their home. One person said, 'The staff are very helpful and kind'. A carer (relative) said, 'The staff here are excellent and nothing at all is too much trouble for them'.

This inspection took place on 16, 17 and 24 September 2015 and was unannounced.

Alandale is a modern, purpose built residential home providing care for up to 35 older people, situated in the village of Whitfield on the outskirts of Dover. The home offers residential accommodation over two floors with large, open plan lounge areas, a conservatory and dining room on the ground floor. There is a stair lift and shaft lift for people to access both floors and there are no changes of levels on each floor, making the home suitable for people with mobility difficulties. There are 35 single bedrooms. 18 of the bedrooms have an en-suite toilet/washroom. There are seven toilets and three bathrooms with special facilities for wheelchairs and those of limited mobility. There is a small courtyard with seating and a back garden so that people can spend time outside in the finer weather and some off road parking spaces for visitors. At the time of the inspection 34 people were living in the home.

There was a registered manager working at the service. A 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.

People and their visitors talked about their decision to move into the home. Some people had come in for a short break from their own home and found that they liked it. One person said, “I liked it so much I decided to stay here.” Another person said, “I was a bit worried about coming into a care home, but once I was here I decided I was better off here than at home. There is always someone around if you need them and I feel safe.”

People said the home was warm and friendly and it was like being in a large family. A person commented, “Since I’ve come in here, time has gone quicker because I’m not on my own. There is always someone here.” People’s friends and relatives had got to know each other and they said they enjoyed visiting the home. Various activities were organised each day and people and their relatives joined in when they wanted to or watched what was happening around them. Some people preferred to stay in their rooms most of the time and others liked to be in the lounges but preferred not to join in with the planned activities. Everybody said they felt there was enough to occupy them and their choices of whether to join in with activities or not was respected. Two parties were organised at Halloween and Easter each year to give people the opportunity to all get together with friends and relatives at the home and to meet everyone. Staff dressed up and everyone talked about how much fun it was.

There were plenty of staff to support people in the way they preferred. People said there was flexibility in the routines of the day and they could get up and go to bed when they wished. They said the staff had got to know them and they had the opportunity to let staff know their preferred way of being supported. People said they maintained as much independence as possible. Some people said they had mobility aids to get around the home and one person said, “My zimmer frame is a life saver I couldn’t manage without it but I always ask staff to walk with me just to make sure I don’t fall.” Staff supported people as much as they needed and at a respectful distance. There were clear plans of support and assessments to make sure risks were considered and strategies were in place to prevent unnecessary accidents.

There was a thorough staff recruitment process, including safety checks, so that the right staff were employed to work in the home. Staff were confident in their roles and had the training and support needed to make sure they had the skills and knowledge to be able to do their job effectively. Staff said the registered manager and owner were very supportive and always available if they had any concerns or needed advice.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Mental capacity assessments had been carried out to determine people’s level of capacity to make decisions in their day to day lives and for more complex decisions when needed. DoLS authorisations were in place, or applications had been made, for people who needed constant supervision because of their disabilities. There were no unnecessary restrictions to people’s lifestyles.

People told us that they felt safe living at Alandale. Staff had received safeguarding training and they were aware of how to recognise and protect people from the risk of abuse. Staff knew about the whistle blowing policy and said they could raise any concerns with the manager, the owner or outside agencies if needed. People said they were well cared for by the staff and nothing was too much trouble which made them feel reassured and content.

People were supported to keep well and healthy and if they became unwell the staff responded quickly and made sure that people accessed the appropriate services. Visiting health professionals including district nurses and doctors were involved in supporting people’s health and wellbeing as needed. Many people had lived locally and maintained the services including the same doctor’s surgery that they had always had. If people required treatment, for example, wound dressings from a district nurse, this was given in a way that respected people’s choice and preference. People’s medicines were managed safely. There were discussions and plans made with people and their representatives (nominated relatives/friends) so that people had the opportunity to say what they wanted if they were to become unwell.

Everyone said they enjoyed the food and mealtimes were set up to be social occasions or people could eat in their own rooms. Staff checked that people had enough to eat and drink and refreshments were available to people and their visitors throughout the day.

The owner and registered manager spent time with people and their representatives (nominated relatives and/or friends) to find out what they wanted and expected from the home and listened to any concerns. People, relatives and visiting professionals were also given surveys so that they could give feedback routinely each year and this could be returned anonymously so that feedback could be more open. From these discussions and the surveys, the owner and registered manager planned the priorities that formed the service development plan for the year. People said that the home was very well maintained. Improvements to what was provided to people and the upkeep of the building were ongoing. This year a new sluice room had been installed with improved equipment and various parts of the home had been redecorated. Following on from people’s views and suggestions the call bell system had been extended into more points in the lounge and staff had their names embroidered on their tunics so that it was easier for people and their visitors to know everyone’s names.

There was a clear complaints procedure and it was easy to make an anonymous complaint by picking up a form near the entrance. People and their visitors said they were happy to talk to the registered manager and staff if they had a concern.

Staff reported accidents and incidents to the registered manager who made sure appropriate action had been taken to reduce the risk of accidents happening again. The owner and registered manager checked for patterns and trends with accidents and incidents in the home overall and made sure that lessons had been learned and changes were made if needed.

Arrangements had been made to respond to an emergency. There was a folder of information including individual emergency evacuation plans and contact details of local services that would be able to assist.