We are delighted to announce our recent CQC inspection report for Corner Cottage has been rated “Good” in all 5 key areas. This is a testament to the hard work and dedication our team there has put into keeping people safe and well looked after during the Covid-19 pandemic.
Our team at Corner Cottage, led by Sally and Bob, have gone over and above to ensure they are leading by example and supporting the whole home to thrive.
The CQC visit took place on the 28th April 2021. Some of the comments represented in the report are..
Throughout the inspection we observed positive interactions between staff and people. Staff showed genuine warmth and compassion when supporting people. Staff knew people well; they knew what was important to them, their likes and dislikes and respected their wishes. This enabled staff to support people in ways they preferred. The service took a person-centred approach to care and support. Staff were respectful about the people they supported and had completed training on equality and diversity. People’s care plans and support records set out aspects of their characteristics, beliefs and preferences to ensure their equality and diversity were respected.
People were supported and encouraged to express their views about how they received their care. A member of staff told us, “It is so lovely here, everything is for the residents, it’s all about them, it’s fantastic. [Person] chooses who they want to support them with their care and their wishes are always respected.” People, family members, staff and health care professionals were all involved in decisions regarding ongoing care and support. Staff supported people to make choices affecting their daily care and support. Support plans considered people’s disabilities, age, gender, relationships, religion and cultural needs. There were weekly house meetings where people were given the opportunity to share information that was important to them and put forward their views, preferences and ideas. Staff offered people encouragement and support to make decisions they may find difficult. Staff respected people’s choices and their rights to do what they wished.

Registered manager, Sally, said of the report, ‘My team have all worked very hard over the last twelve months, during this very difficult time in the world, and this wonderful outcome reflects the amount of effort and dedication we have all put in.’

Thank you so much to the wider team, families and individuals all involved with Corner Cottage to make it such a wonderful place to live.
You can see the full CQC report here:
https://api.cqc.org.uk/public/v1/reports/55983b59-4d07-4b95-b3a7-60ab673fa8d4?20210609120000
Romaine LawsonDirector of Operations

We recognise as a company that working with the people who can specialise in the best proved systems in our field will afford us the time to do what we do best and provide outstanding care and support. 

Quality Compliance Systems are a market leader in the Care Sector for providing expert written Policies and Procedures, with over 50,000 users accessing the System daily.

QCS has provided Apple House documents completely personalised to our company.

The System is an online platform in which each staff member will be provided their own login details and will be able to access all available policies and procedures. Each person will also have their own reading list which will assist in their individual training pathway.

As part of the partnership, Quality Compliance Systems offers a Customer Care Support Team to help our teams every step of the way. Our staff teams will be able to contact them at any point for any support needed.

Apple House and QCS are committed to supporting all employees, and we welcome people to come to either of us with any questions or feedback.

The Managers of each Home have been undergoing individual training sessions for the new system and are now available to answer any questions.

One of the joys of implementing this system is the instant updates and an easy-to-use online interface; the system provides fast access to up-to-date policies and procedures. We look forward taking this forward and will keep you updated with the implementation across the company.

— Romaine Lawson, Director of Operations, Apple House Ltd

CQC is the independent regulator of health and adult social care in England.  The inspection was unannounced and took place over two days on the 27^thFebruary and the 1^stMarch 2018.

Our teams have demonstrated their unfailing commitment to providing a high standard of care and support at Apple House.

We would like to share below some of the report’s findings and you can also view the full report HERE

Safe

We spoke with three people who lived at the home, all of whom were living full active lives. They all told us they were happy living at Apple House and were keen to be part of the inspection. No one had any concerns about safety and they made comments such as: “I am very happy here”, and, “This is a nice place to live”.

The registered manager had also taken steps to make sure people’s care was delivered as safely as possible as all aspects of people’s care had been risk assessed. The risk assessments showed that the service was not ‘risk adverse’, as people were supported to take calculated risks in meeting their objectives.

One person had been assessed as having memory problems; however, they were supported to maintain their preferred routine of going out in the evenings and arrangements were made to support them with this goal.

This person was also the in-house Fire and Health & Safety officer. They worked with staff and had their own picture format to work from. This helped them identify risks or hazards in the way that they could understand. They were supported by a member of staff and assisted with fire evacuations and monthly health and safety checks. The registered manager told us this has helped this person’s esteem by being valued and included in the safety of their own home.

The home had recently had an audit of their medicines’ management by their pharmacist.  The report showed good compliance with medicines guidelines.  The registered manager shared knowledge with their medication auditor as they did not know the risks to using paraffin emollients. They said they would feed the information, which was taken from NICE/ CQC and NHS guidance, back to their pharmacist team.

Effective

People were satisfied about how their care and support was managed at Apple House and fed back to us that their consent was always agreed before any changes to their routine. Health and social care professionals also commented positively about the support people received at the home.

The home had a small staff team who felt well supported by the registered manager as well as the directors of the company.

Records showed that staff had regular supervision meetings and annual appraisal meetings with the registered manager. In these meetings they reflected on their work, the people living at Apple House, as well as training and development needs.

People were mostly able to make decisions for themselves about various aspects of their care and support. The registered manager and staff were aware of the requirements of the Mental Capacity Act 2005 in relation to supporting people wherever possible to make their own decisions. People’s consent had been documented in relation to areas such as care and treatment, medication, sharing information with professionals and having photographs taken. People told us that their consent was always gained and that staff respected their decisions.

Where people lacked the mental capacity to make decisions about aspects of their care, staff were guided by the principles of the Mental Capacity Act 2005 to make decisions in the person’s best interest.

Care plans recorded that people had been involved and supported as far as possible in making any decisions. Best interest decisions had been made on the basis of the least restrictive intervention necessary. Staff had all had training in MCA.

Staff encouraged and supported people to eat healthily and to be involved in shopping, cooking and budgeting. For example, one person’s cookery folder showed how staff had worked with them. Real time photos had been used as visual prompts to help the person remember what actions were needed to complete the task.

Caring

People and health and care professionals all told of how supportive the staff were at Apple House.

We discussed equality, diversity and human rights with the registered manager. Staff had a good understanding about treating people as individuals and ensuring they were given choice and their preferences respected. Staff received training in diversity, equality and inclusion.

Staff we spoke with had very good understanding of people, how to support them and knew of their goals as detailed within care plans. Each person had a communication plan and staff knew how to communicate with each individual.

Staff were aware of people’s preferences and respected their choices. People’s records included information about their personal circumstances, likes and dislikes and how they wished to be supported. For example, care plans referred to people’s preferred routines and how they liked to spend their day.

Responsive

An advocacy worker who had been engaged to work with one person commented; “It is refreshing to meet such a dedicated staff who have such a strong bond with the residents. It is very clear that (person’s name) enjoys life at Apple House, and this is solely due to the professionalism and genuine warmth of the staff to the residents. Believe me, there are not many homes that I would endorse without a second thought.”

Each person had an up to date personal care plan. The plans detailed people’s needs and how they should be supported. The plans gave good information about the whole person; their health, social, spiritual and emotional needs and identified goals set with that person. The plans were up to date and shared with the people living at the home so that they were fully involved in planning what they wanted to achieve in the future. For example, the registered manager told us that staff at Apple House and family had worked with one person with a mental health condition to remain stable for the past 18 months. The professionals involved had agreed to sign a support plan the person had written with the help of staff. This person had also with support written their own support plan to lower their stress levels, demonstrating the service encouraged people to contribute to planning their care.

People were enthusiastic to share their experience of the home and were happy for this report to reflect the full lives that they were able to enjoy because of the support and assistance of the staff.

Each person had varied, differing interests and the staff had worked with people to ensure people individuality was respected.

Well-led

The home was well-led by the registered manager who had worked at the home for many years. The directors of the company also took an active part in supporting the registered manger and people living at the home. They visited the home at least once a month to support the registered manager and also to review the performance of the service.

The company was a finalist in the National Learning Disabilities and Autism Awards 2017 for Employer of the year and also for 2018. The award for 2018 was in relation to the ‘Breaking Down Barriers’, which celebrates and recognises an individual or organisation who has worked to make sure people get clear information and are able to contribute their views and experiences.

One of the directors had been awarded ‘Director of the Year’ and had also been a finalist for a lifetime achievement award with a local initiative recognising women’s achievement in business. The Managing Director and the Director of Operations gave a seminar presentation for Westminster briefing, one of Europe’s leading political information, public affairs and policy communication specialist. This service feeds into the House magazine, the weekly business publication for the houses of parliament.

The registered manager had sought feedback from staff members with questionnaires asking about their working life. This was in addition to the support, supervision and appraisal given to all staff. The registered manager gave feedback in an open letter to the team to motivate and inspire the team.

— CQC

We would like to extend our warm congratulations to Jayne Jackson, Registered Manager at Apple House care home, and her team, for their hard work and total dedication to the individuals they support. What an amazing CQC report and a very well deserved rating of Good!

— Romaine Lawson, Director of Operations, Apple House Care Homes.

🔊 Listen to this

You may well have been hearing a lot in the media around General Data Protection Regulations (GDPR) and more than likely you would have been receiving emails from various companies you may have signed up to once upon a time asking if they can still contact you in the future. This is all in readiness for the new GDPR, which comes into force on May 25^th 2018.

GDPR will replace the Data Protection Act of 1998 (DPA), which was a way to implement the EU Data Protection Directive of 1995.

As with the DPA, the GDPR aim to ensure that individual’s personal data is processed lawfully, fairly and with transparency.

So, what have we been doing at Apple House Ltd to prepare for this change? Well, we have been looking at our processes to ensure that we continue to be compliant. Many of the principles are the same as with the current DPA so our approach has been to look at the areas where we need to implement additional processes or information.

Our preparation has included;

Awareness – Raising awareness within our company and looking at training opportunities.

Information we hold – Carrying out an information audit.

Communicating privacy information – Revising our privacy statement.

Individual’s rights – Checking the systems in place reflect all the rights individuals have with regard to their data.

Subject access requests – Updating and renewing procedures.

Lawful basis for processing personal data – Identifying the lawful basis for all information which is processed.

Consent – Reviewing how we seek, record and manage consent.

Data breaches – Reviewing process in place.

Data protection impact assessments – When and how to implement.

The Information Commissioner’s Office (ICO) offers full information and guidance on GDPR. Apple House Ltd is registered with the ICO and is committed to providing the highest of standards.  

We are continually working to ensure that all new legislation, standards and best working practices are implemented in the most appropriate way. We always welcome the opportunity to share working knowledge and innovative practices.

Please contact us if you would like to share or even showcase your ideas. Cooperation and communication are celebrated here at Apple House Ltd.

— Romaine Lawson, Director of Operations.

🔊 Listen to this

Jane Montrose, Managing Director of Apple House care group, and Romaine Lawson, Director of Operations, were thrilled to be invited to speak at a Westminster Briefing in London last week.  The invitation followed the CQC ‘Outstanding’ rating of one of the group’s homes and focused on how leading services prepare for CQC inspections and met the updated CQC Assessment Framework.

In attendance were leaders of charitable trusts and housing associations, as well as heads of councils from around the country and other care provider heads, totalling twenty attendees. The discussions formed the first step in public policy debate which informs Westminster and Whitehall and also goes into the ‘House’ magazine which is distributed to Members in the Houses of Parliament.

A twenty-minute window was allotted to Jane and Romaine but this ran on to an hour as questions streamed in for them following their speech, culminating in the chair declaring, ‘One more question only!’

Romaine said after, “I am absolutely buzzing from this incredible experience, what a fascinating day it has been!”  Jane agreed, adding, “We hope to be invited by Westminster Briefing to speak again in the future.”

🔊 Listen to this

Jane Montrose, Managing Director, and Romaine Lawson, Director of Operations of Apple House Ltd were thrilled to have accepted an invitation to London to be guest speakers at next week’s Westminster Briefing on ‘Care Home Inspections: Meeting the Updated CQC Assessment Framework.’

Joining Jane and Romaine in also speaking at the Westminster Briefing is Geraldine Strathdee OBE, former National Clinical Director for Mental Health and National Professional Advisor for the Care Quality Commission (CQC).

CQC’s new updated assessment framework for community and residential adult social care services comes into effect this winter. Discussed at the briefing will be a comprehensive overview of the guidance on care standards for care homes including best practice and changes to the key lines of enquiry.

In 2015, NHS England published reports highlighting the widespread inappropriate use of antipsychotics and other medicines used to treat mental illness in people with learning disabilities.  And, following these reports, NHS England led a ‘call to action’ which brought together representatives of professional and patient groups to make sure changes were made to these bad practices.

‘It is estimated that every day about 35,000 people with learning disabilities are prescribed psychotropic medicines when they do not have a diagnosed mental health condition, often to manage behaviour which is seen as challenging.’– NHS England

Thereafter, a three year strategy was founded which runs until 2019, centred upon finding other ways to ensure people receive the help that they need without the inappropriate use of medication.

Of course, medication is not bad per say.

Where medication is the right pathway for an individual, STOMP is about getting the right medicine, that medication reviews are regular and that individuals are involved and supported in decisions affecting them. It highlights the importance of inclusion of families and social care providers in supporting people.

STOMP is gaining momentum!

Here at Apple House care homes the principles of STOMP are carved deeply into our work and always have been.  However, we welcome this formalised approach which is raising awareness to a long history of inappropriate medication of people with learning disabilities.

Increasingly, health professionals and groups such as the British Association of Social Workers, Voluntary Organisations Disability Group, Royal College of Speech and Language Therapies, and Care Management Group, are joining the Royal Colleges of GPs, Nursing, Psychiatrists and the NHS, in pledging to uphold the ethos of STOMP.

Does this mean there is zero medication in Apple House care homes?

Of course medicine is still the appropriate choice for some people. What we believe, though, is that medication might be appropriate right now but that does not mean it needs to necessarily be a long term pathway.  Here, Jayne Jackson tells us just a few ways in which Apple House care home is embracing the STOMP project:

“If we give ‘as required’ medication, we immediately liaise with the mental health team so that we are all participating in the monitoring of the medication’s effectiveness and exploring why it was needed, what could and would work better to prevent the need for ‘as required’ medicine.

We use ‘flat mood’ charts as part of investigative work we are undertaking with Y and we noticed an increase in Y’s anxiety and darkening mood.  [This should help his psychiatric doctor understand if his low mood is linked to behaviour or mental health; this will also reflect on what medication he will be taking]

We know that sleeping well has been proven to keep Y’s mental health well and so we focus, with Y, on relaxation techniques, on ensuring Y’s environment is conducive to peace, calm and rest, and that Y is encouraged to talk about stresses or thoughts or emotions that might prevent a good night’s sleep.  Although guidelines are in place for the use of an as required medication, we have not needed to administer this for five years because we achieve results by more organic means.

We request referrals and screening tests – this ensures that underlying physical health is good and it also alerts us to any possible effects of reductions in medication.” — Jayne, Registered Manager, Apple House care home.

Communication is key!

Communication with the individual, with their mental health team, GP and community nurse. With family and outside agencies.  Together we ensure medication is regularly reviewed, side effects minimised and alternatives explored and used alongside or instead of medicine.

“We have a fantastic relationship with the people we support, their family and professionals.  We work as a team.” — Jayne, Registered Manager, Apple House care home.

What about alternatives to medicine?

We have previously reported, right here on our blog, about the extensive benefits of sensory stimulation via sensory rooms, sensory gardens and other creative means to defuse challenging behaviour.

As a ‘family friendly’ organisation, we encourage loved ones to be intrinsically involved unless an individual does not want this. We draw on their knowledge, the likes and dislikes and the past of the individual we support.  Triggers to mood change and behaviour escalation are identified and form the cement that underpins care plans and positive behaviour management.

“We as a provider carefully cherry-pick the best staff, the most compassionate and insightful team members who will look past the presenting behaviours and really see the individual.

Just today, at a senior team meeting, I introduced the team to an exciting new handbook called ‘Please Tell Me,’ by John’s Campaign of which we are members. This is a book by and for the people we support. It is their history, their present, and their future, as perceived by them and for them. Not only might it be cathartic to work on their book (with or without support as needed), but it provides a precious tool to record memories, to log events that have shaped them and thoughts that make up the person they are.

If we can see each person holistically, then together we can be more creative in finding alternative ways to medication to ensure life is full and pleasurable and safe.” –Jane Montrose, Managing Director, Apple House care homes.

 Here are some useful links for further reading:

Care Management Group, on STOMP: CLICK HERE

NHS England, on the STOMP pledge: CLICK HERE

🔊 Listen to this

Ms. Sutcliffe’s tweet followed a CQC national press release today announcing Summerwood care home’s ‘Outstanding’ rating, the highest rating possible.  Following the press release, Apple House Ltd were delighted to be contacted by local press taking up this good news story in an age when, all too often, the care sector is in the spotlight for more negative reasons.

Apple House will be holding a celebratory party at Summerwood next month.

Please follow us on social media: @AppleHouseLtd and https://www.facebook.com/AppleHouseCare/

• The public – people who use services, families and carers – know what high-quality care looks like and what they have the right to expect.
• Staff working within adult social care understand what high-quality care looks like and how they can contribute to delivering it.
• Providers of adult social care share a clear vision and commitment to providing high-quality care.
• Commissioners and funders of adult social care support the commissioning of high-quality care and high-quality integrated care.
• National bodies (including regulators and improvement agencies) support integrated working across the system to champion high-quality care.

🔊 Listen to this