CQC report explained · a residential care home
What the CQC found at Alderson House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were safe and risks were generally well managed. However, some risk assessments lacked enough detail to guide staff about individual risks and behaviours.
- Effective?
- Good
- People's health, nutrition and support needs were well managed. Staff received training and worked with health professionals when needed.
- Caring?
- Good
- People were treated with dignity and respect and involved in decisions about their care. This rating improved from Requires Improvement at the previous inspection.
- Responsive?
- Good
- People received personalised support, kept in touch with relatives and took part in activities they enjoyed. Some care plans did not fully reflect people's needs, and end of life preferences were not always recorded.
- Well-led?
- Requires improvement
- Managers were approachable and promoted a positive, person-centred culture. However, audits were not fully effective and did not give enough oversight of care plan quality or medicines management.
What inspectors found, February 2020
Alderson House was rated Good overall, but inspectors found weaknesses in quality checks and care plan records.
This was an unannounced planned inspection on 13 January 2020. One inspector spoke with people, staff, managers and relatives. They reviewed care records, medicines records, training, recruitment and management records.
The home was rated Good for safe, effective, caring and responsive care. People were described as safe, treated with kindness and supported to make choices. Staff understood people's needs and helped them maintain relationships, enjoy activities and access health care.
The home was rated Requires Improvement for being well-led. Quality checks did not reliably find gaps in care plans or medicines monitoring. Some care plan information was incomplete, hard to find or conflicting, although managers had started work on a new electronic quality monitoring system.
People felt safe
People told inspectors they felt safe. Staff understood how to report safeguarding concerns, and managers used incidents to improve practice.
“People we spoke with felt safe living at the service” from the report
Kind and respectful staff
Inspectors saw positive interactions. Staff supported people's privacy, dignity, independence and choices.
“Staff worked with people to encourage their independence showing kindness and respect when speaking with them.” from the report
Health and nutrition support
The home supported people's diets, health appointments and treatment. Staff worked with health professionals and followed their guidance.
“People's nutritional and health needs were well managed” from the report
Activities and relationships
People were supported to see relatives, go out, volunteer and enjoy hobbies such as walking, bird watching, crafts and games.
“People enjoyed a variety of social activities.” from the report
Care plans lacked detail
needs fixingSome care plans did not clearly describe people's needs or the support staff should provide. Information could be difficult to find or conflicting.
“The information in people's care plans did not always reflect their needs.” from the report
Quality checks were not reliable
needs fixingCare plan audits had not found the gaps identified by inspectors. Medicines audits did not provide enough oversight of refusals and stock levels.
“There were systems and processes in place to monitor the quality of the service, however, these had not been fully effective.” from the report
Some risk information was incomplete
needs fixingSome risk assessments did not give staff enough written guidance, including about how to respond to behaviours that challenge. Staff understood the risks in practice.
“There was a lack of information in some people's risk assessments to provide staff with guidance on managing people's individualised risks.” from the report
End of life wishes were not always recorded
minorPeople's end of life preferences were not always included in care plans. Managers accepted that people's wishes about discussing this should be recorded.
“People's end of life needs were not always recorded in their care plans.” from the report
- 01How have you improved the care plans that were difficult to find, incomplete or conflicting?
- 02How do you now record and review each person's risks and the strategies staff should use when they become anxious or display behaviours that challenge?
- 03How do you monitor repeated medicine refusals and medicine stock levels?
- 04What changes have resulted from the new electronic quality monitoring system, and when will its impact be reviewed?
- 05How will you record each person's wishes about end of life care if they do not want to discuss the subject?
This was an unannounced planned inspection covering all five CQC questions, with the home rated Good overall and Requires Improvement for well-led. This explanation was written from the published report of 8 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2019
Rated Requires Improvement; inspectors found safe and effective care, but concerns about dignity, choice and quality checks.
This was an unannounced inspection on 13 February 2019. One inspector and an expert-by-experience spoke with people living in the home, relatives, staff and the manager. They also observed care and checked care records, medicines records, staff files and management records.
The home was rated Good for Safe, Effective and Responsive. People were protected from abuse, staffing levels were sufficient, medicines were managed safely, and staff knew people's needs. People generally enjoyed the home, meals and activities, and received support with health appointments.
The home was rated Requires Improvement for Caring and Well-led. Some people said staff were bossy or treated them like children. Inspectors also found that heating was not always adequate and that quality checks had not identified important issues about people's treatment, choices and activities.
The overall rating changed from Good at the previous inspection to Requires Improvement. The report says the home planned or had already made some changes, including reviewing risk assessments, making hot drinks available, adding personal preferences to records and planning to employ an activities coordinator.
People felt safe
People and relatives said the home was safe. Staff had safeguarding training and knew how to respond to possible abuse or harm.
“People told us they felt safe with staff.” from the report
Medicines were managed safely
Inspectors found medicines were securely stored, given as prescribed and checked by audits. Staff had to be trained and assessed before giving medicines.
“Records showed that medicines had been supplied as prescribed.” from the report
Staff knew people's needs
People and relatives said staff were trained and understood how to support them. Care plans were personalised and health appointments were supported.
“People were supported by staff who had ongoing relevant training.” from the report
Choice and activities
People could choose meals and take part in activities such as shopping, walks, college courses and helping at an animal rescue centre.
“People were involved in choosing what activities they wanted to do such as going shopping and helping at an animal rescue centre.” from the report
Dignity and respect
seriousSome people said staff treated them like children, were bossy or did not treat them equally. Inspectors also witnessed a person being ordered to remove their coat from the dining room.
“Two people said they were not always treated with dignity and respect.” from the report
Limited everyday choices
needs fixingSome people said they could not always have a hot drink when they wanted one. The manager later confirmed that hot drinks were always available, but inspectors found that the earlier practice limited choice.
“Some people said they were limited as to when they could have a drink.” from the report
Cold areas
needs fixingThe conservatory and dining area were chilly. The manager said the heating arrangements would be reviewed.
“A conservatory and dining area were chilly even though there were heating appliances in them.” from the report
Care plans lacked personal detail
minorCare plans did not contain enough information about some people's likes, dislikes, hobbies and interests. The manager said this would be added.
“Care plans did not have detailed information about people's likes and dislikes and their hobbies and interests.” from the report
Complaints information
needs fixingPeople knew they could speak to staff but were unsure how to make a complaint. The complaints procedure did not include all relevant contact information.
“People knew that they could tell staff if they were worried about anything, but were unsure how to make a complaint.” from the report
- 01What has changed to make sure people are treated with dignity and are not spoken to or managed in a bossy way?
- 02How do people now choose when to have hot drinks and make other everyday lifestyle choices?
- 03How do you check that all rooms and shared areas are warm enough?
- 04Has an activities coordinator been employed, and what structured activities are now available?
- 05How are complaints explained to people, and does the procedure now include the correct external contacts?
This was an unannounced inspection of the care home covering all five CQC questions, including the premises and care provided. This explanation was written from the published report of 28 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Alderson House
3 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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9 live-in carers within about an hour of Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.