CQC report explained · a residential care home
What the CQC found at Alpha House - Huddersfield
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicine records had gaps and one infrequently used medicine was out of date. Some risk assessments, behaviour records and physical intervention plans did not give enough detail.
- Effective?
- Requires improvement
- People were supported with meals, weights and health appointments. However, capacity assessments, best-interest decisions, supervision, training and appraisals were not consistently up to date.
- Caring?
- Good
- Inspectors found people were treated with compassion, dignity and respect. Relatives spoke highly of the staff and said people were treated as part of the family.
- Responsive?
- Requires improvement
- Care plans were often detailed, but one was a lower standard and reviews were not consistently person-centred. Activities and personal goals were not always recorded or delivered as planned.
- Well-led?
- Requires improvement
- The home had audits and management meetings, but checks did not consistently identify problems. The provider had not reported some significant events to CQC.
What inspectors found, July 2019
Rated Requires Improvement; inspectors found kind care, but concerns about medicines, risk records, staff training and management oversight.
This was an unannounced inspection on 11 and 13 June 2019. Inspectors spoke with a resident, staff, managers, relatives, an advocate and a social worker. They reviewed care plans, medicine records, staff files and quality checks.
The home cared for three people with autism and/or a learning disability, and could support four. Inspectors found staff were caring and people were treated with dignity. People had choice over meals, support to attend health appointments and opportunities to build independence.
However, medicines were not always recorded or managed safely. Some risk plans and behaviour records lacked detail. Staff supervision, training and appraisals were not up to date. Capacity and best-interest decisions were not always recorded, and the provider had not reported some significant events to CQC.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were also rated Requires Improvement. Caring was rated Good. The report says the provider took immediate action on the medicine concerns, but CQC required an action plan and continued monitoring.
Kind and respectful staff
Inspectors saw staff treating people with compassion, dignity and respect. Relatives were positive about the care and felt people were safe and well supported.
“Staff treated people with compassion, kindness, dignity and respect.” from the report
Choice and independence
People were supported to choose meals, take part in activities and develop skills. The home was designed around individual needs, including an apartment for someone with higher independent living skills.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Health support
Staff supported people to attend hospital appointments and see health professionals when needed. People's weights were monitored and staff supported regular dental appointments.
“People were supported to see a dentist at regular intervals.” from the report
Safe recruitment and safeguarding awareness
Staff recruitment practices were safe. Staff had safeguarding training and understood what to do if they suspected abuse.
“Staff had been trained in safeguarding adults.” from the report
Medicine safety
seriousMedicine administration records had gaps and discrepancies. One medicine was out of date, cream charts were missing and night staff had not been trained to administer medicines.
“Medication administration records (MARs) contained some discrepancies and gaps where staff had not signed to say the medicine had been administered.” from the report
Risk and behaviour records
seriousSome risk plans did not explain clearly enough how staff should reduce risks. Behaviour records were not consistent, making it harder to understand triggers and plan effective support.
“Risk assessments and management plans were of inconsistent quality.” from the report
Staff training and supervision
seriousSupervision and appraisals were not up to date, and some training was incomplete. Knowledge checks were not used consistently to confirm that training improved staff skills.
“The lack of timely supervision, training and appraisal for all staff posed a risk to the delivery of high-quality care.” from the report
Mental capacity records
seriousDecision-specific capacity assessments and best-interest decisions were not always recorded. There was no capacity assessment for medication, and monitoring of one liberty safeguard condition had been delayed.
“We found inconsistencies in the recording of decision specific capacity assessments and best interest decisions.” from the report
Management checks and reporting
seriousAudits did not consistently find problems with medicines, care plans or incidents. The provider had also failed to notify CQC about some events affecting people's safety and welfare.
“The provider did not have effective systems in place to assess, monitor and improve the quality of service provided.” from the report
- 01Have all medicine records been checked and corrected, including the out-of-date medicine, cream charts and missing administration signatures?
- 02Have all night staff now been trained and assessed as competent to administer medicines?
- 03How are risk assessments, behaviour records and physical intervention plans now checked for enough practical detail?
- 04Are decision-specific capacity assessments, best-interest decisions and liberty safeguard conditions now recorded and monitored?
- 05How are you ensuring staff supervision, appraisals, specialist training and person-centred care reviews happen on time?
The inspection was prompted by concerns about people's safety and examined the risks, while also rating all five CQC questions. This explanation was written from the published report of 25 July 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.
What inspectors found, December 2018
Rated Good; inspectors found kind, safe and personalised care, but some cleaning, medicines auditing and management support needed attention.
This was an unannounced inspection on 6 November 2018. The inspector observed how people were supported, reviewed care and medicines records, checked staff recruitment and training, and examined quality and safety records. The building was also checked.
The home supported three people with learning disabilities. Inspectors found enough staff, safe recruitment, medicines given as prescribed, suitable training, good health support and care that respected people's dignity, choices and independence.
The home had personalised activities, easy-read information and systems for complaints and quality checks. Some areas needed attention, including cleaning and the medicines audit tool. Staff questionnaire responses about support from the provider were also mixed.
The overall rating was Good, with Good ratings in all five areas. This was unchanged from the previous inspection in February 2016.
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs and saw staff respond promptly. Recruitment checks were completed before staff started work.
“Staffing levels met the needs of people living at the home.” from the report
Kind and respectful care
Staff used people's preferred names, respected their privacy and understood how they communicated without speech. People appeared comfortable and relaxed with staff.
“Staff were kind, gentle, patient and engaging. They provided people with good eye contact and used appropriate touch to provide reassurance and encouragement.” from the report
Personalised support
Care plans recorded people's backgrounds, preferences, routines and goals. Activities were based on individual interests and supported the development of skills and confidence.
“Each person had a person-centred plan which gave clear information about their background, histories, family, social networks, preferences, personalities, habits, qualities, likes, dislikes, their goals, routines, social and family support and what was important to them.” from the report
Health and medicines
People received medicines as prescribed and staff worked with health professionals. Staff monitored health changes and acted promptly when concerns arose.
“People received their medicines as prescribed and medicines were managed safely.” from the report
Training and support for staff
Staff had training, supervision and appraisals to help them carry out their roles. They understood the Mental Capacity Act and how to support choice.
“Staff had received appropriate training and had the skills they required in order to meet people's needs.” from the report
Medicines audit was basic
needs fixingThe medicines audit did not cross-check stock against administration records. The locality manager said the audit tool would be improved.
“For example, it did not cross reference medicines stocks with administration records.” from the report
Some cleaning needed
minorInspectors said the medicines cabinet and carpet in the medicines room needed cleaning. The manager said this would be dealt with immediately.
“We also noted the medicines cabinet and the carpet in the medicines room would benefit from cleaning.” from the report
Mixed staff feedback about management support
needs fixingFour of five staff questionnaire responses rated support from the registered provider as poor. The locality manager said the reasons would be investigated and an action plan developed.
“Of the five staff responses, four rated support from the registered provider as poor.” from the report
- 01What changes have been made to the medicines audit so that stock is cross-checked with administration records?
- 02Has the medicines cabinet and carpet in the medicines room been cleaned, and how is this now monitored?
- 03What did you learn from the staff feedback in which four of five responses rated provider support as poor?
- 04How often is the registered manager at this home, given that they are also registered for another home?
- 05How do you make sure activities and daily routines continue to reflect each person's preferences and goals?
This was an unannounced inspection covering all five CQC questions, including observations, records, staff files, medicines, the building and quality systems; the previous Good ratings were confirmed. This explanation was written from the published report of 5 December 2018 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 Alpha House - Huddersfield
3 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- July 2019Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 24 December 2010.
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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