Adalena House

We assessed all quality statements for the key questions of safe, effective, caring, responsive, and well-led. We found the provider was in breach of the legal regulations in relation to safe staffing and safe governance and oversight.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. We found the service demonstrated understanding of the guidance, but did not always apply it.

Staff were not always recruited in a safe manner, and we could not be assured that staffing levels were always safe. Staffing rotas that we reviewed were not always accurate and identified that some staff had been working long hours in contravention with working time regulations. Medications were not stored or managed safely. Staff reviewed assessments taking account of people’s communication, personal and health needs. However, these reviews were not always documented. Care was not always based on latest evidence and good practice, and it was not always clear that people were involved in the assessment of their needs.

People had enough to eat and drink to stay healthy. Staff worked with all agencies involved in people’s care for the best outcomes and seamless transitions when moving between services. They monitored people’s health to support healthy living; however, this was not always consistently documented. Staff made sure people with capacity understood their care and treatment to enable them to give informed consent. Staff did not always involve those important to people, when making decisions in people’s best interests, and staff had not always documented that the least restrictive options available to people were considered.

Staff treated people with kindness and compassion, and their privacy and dignity was protected. Staff did not always treat people as individuals; we witnessed people being referred to as the “the gang” and “the boys.” Staff supported people’s preferences, people had choice in their care and were encouraged to maintain relationships with family and friends. Systems and processes were not always in place to identify concerns and drive improvements. We have asked the provider for an action plan in response to the concerns found at this assessment