Alderwood L.L.A. Limited - Irchester

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People were generally treated with kindness, empathy and compassion. Staff did not always know how to support people to do what they enjoyed and did not promote people’s independence, choice and control. People did not receive consistent individualised care. We saw some positive staff engagement with people that showed they knew people’s individual needs, routines and what was important to them. However, we also saw a lack of staff engagement with people. Further work was required to embed this within the service. Our findings showed that the service was not meeting the statutory guidance Right Support, Right Care, Right Culture because people were not always empowered to be as independent as possible. However, the management team provided support and coaching alongside external health professionals to address this area.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us the staff are caring and compassionate and treat their loved ones with dignity and respect. One relative told us, “The staff are welcoming, they answer the door and we’re on first name terms. We only go into the office and that’s for meetings. The staff come to the door and [Name] always looks smart and clean and tidy, ready to go.” However, through observation of staff approach, we were not assured staff skill, training or competency had been assessed or monitored by the management team to ensure they understood people’s emotional expression or distress and could respond in a compassionate way that reflected the person’s needs.

Staff had completed training and understood their responsibilities to ensure people were treated with dignity and respect. The registered manager told us, “Observational spot checks are completed on staff throughout their shifts and feedback is given to them. There is information within their care plans for staff to follow.”

External professionals told us staff lacked effective skill and knowledge regarding people’s emotional, well-being and communication needs. Concerns were raised that staff teams were not providing meaningful and purposeful engagement.

Staff lacked skills in meaningful engagement with people, mostly directing people to complete a task or transition to another room. People spent a lot of time in their rooms and staff congregated on the landing. In communal areas staff stood away from people and observed them across the room. The regional manager spoke with staff and asked them to engage with people during our visit.

Relatives told us Staff knew their loved ones well. One relative told us “‘They can speak single words. You can tell if they are upset, the staff understand them well.’ Another relative told us “‘They speak kindly to them, it’s person-centered, they will ask [Name] and consult them.”. However, we observed staff ways of working did not always ensure people’s communication needs were consistently used by staff. Assessed communication booklets were not used with people to ensure people could make informed decisions or express their emotions.

One staff member told us a person’s heritage is supported through their music and going to a supermarket for foods which remind them of their childhood. The manager told us “[Name] has recently started going to the Caribbean food shop, they buy various snacks and bring back ideas for mealtimes in the home” However, some staff told us people that live at the service do not have any social, cultural or religious needs that they need support with. This meant not all staff were aware of people’s social, religious or cultural needs or how to support people effectively to ensure their care is meaningful and purposeful.

We did not observe staff using communication booklets that had been identified in peoples care records. The registered manager told us these were being reviewed, however, they were still in service at the time of the assessment and no alternative had been sought. This meant people did not have their preferred method of communication assessed and staff lacked guidance on how to support people with meaningful interactions or effective communicative distraction techniques

Some people’s care records provided staff with guidance about their individual cultural and religious needs. For example, a person's care plan detailed their cultural and religious needs and preferences, and how this impacted on their care and support needs. However, not all plans had been reviewed and updated into the new care planning format. These plans lacked sufficient detail or guidance for staff to follow. The registered manager had an action plan in place with clear timescales to ensure all care records were reviewed and updated.

People’s relatives told us there was a lack of engagement and forward planning to ensure activities are planned and offered regularly by staff. One relative said, “We have bought several sensory stimulation activities in to the service to keep [Name] engaged and calm, but the staff never use them. There is a lack of motivation from staff and nonexistence of meaningful activities for [Name]. They treat [Name] as if they are a 95-year-old person in an armchair with three bodyguards around them.”

Staff told us they have regular visits from family members and that people often go out with their family or visit their family home. The registered manager told us they ensure regular update emails and phone calls are shared with families that cannot always visit

Two people were supported to the gym to complete a Pembleton cycle class. However, other people’s planned activities included a local walk. One person could not go out due to lack of staffing and another person had their activity of swimming changed due to lack of skilled staff to either drive the transport or go into the pool with the person.

Not all peoples care records provided guidance for staff about their preferred routines, likes and dislikes and activities within the home and in the community they enjoyed. The manager was in the process of updating care records for people, however, this had not been embedded for all people living at the service at the time of the assessment. The registered manager told us “This is an ongoing piece of work, I haven’t been here long but the plans that have been completed are much improved”. The registered manager provided us with an action plan with timescales for care records to be updated and relevant information and guidance for staff to be in place. There was a lack of systems and processes in place to ensure staff were allocated to support people. Staff told us allocations are decided on day of their shift. This meant staff did not have the time to plan positive outcomes with people and ensure meaningful activities were prepared for.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.