An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? As part of this inspection we spoke with six people who use the service, three visitors, the registered manager, the head of care, two care staff and the cook. We reviewed records relating to the management of the home which included, six care plans, daily care records, risk assessments, audits, policies and staff duty rotas. We also spoke to the local authority Commissioners.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
Is the service safe?
People had been cared for in an environment that was safe and there were enough staff on duty to meet the needs of people living in the home. A member of the management team was available on call in case of emergencies.
Care plans gave guidance and instruction to staff on how to meet people's needs in a way which minimised risk for the individual. They ensured that staff had the information necessary to support people safely. Staff were well trained and well supported to enable them to provide safe care to the people who lived in the home.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We spoke with the manager with regard to the Supreme Court ruling which widened and clarified the definition of deprivation of liberty. They were aware of the ruling and had been in contact with the local authority deprivation of liberty safeguards (DoLSs) team. At the time of the inspection no-one in the home had a DoLS authorisation and the manager was awaiting further guidance from the local authority.
Is the service effective?
People all had an individual care plan which set out their care needs. People were referred when necessary to a range of health care professionals including GPs, tissue viability nurses and dieticians. Directions from professionals were recorded accurately in the care plan and staff we spoke with knew how to access and follow them.
We observed staff supporting people in a friendly, kind and patient manner. We saw choice being offered and explanations given. We saw staff engaged with people whenever they entered a room, people responded positively to this interaction by replying or smiling. One person we spoke with said: 'if I can't be in my own home, I want to be here and nowhere else.'
People were supported to eat and drink sufficient amounts to meet their needs. We observed the lunch time activity and spoke with people afterwards. They told us they thought the food was, 'very good.' Relatives of people living at the home told us they felt the food was good and there was plenty of choice.
During the inspection we saw staff supporting people with activities. People were encouraged to join in and we saw people laughing, smiling, clapping and singing.
Is the service caring?
People said they were supported by kind and attentive staff. One person said: 'staff are very good, they really care, care with capital CARE.' Our observations confirmed this and we saw people being spoken to politely and with respect. Staff showed patience and were encouraging when supporting people in everyday tasks and activities. One relative said they were very happy with the care their loved one received, and added they didn't think they would still be alive if it wasn't for the care they had received in the home.
Is the service responsive?
People's needs had been assessed before they moved into the home. People's needs were reviewed with them and their relatives as appropriate. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were important to them and they had been supported to maintain relationships with their friends and relatives.
We spoke with six people and three relatives of people who use the service. They told us they could talk to staff if they were unhappy about something. They all said they felt confident they would be listened to. People told us they knew how to make a complaint if necessary. One told us: 'the office door is always open; I can say if something isn't right and it will be dealt with so there is no need for anything to go further.'
Is the service well-led?
Quality assurance processes were in place. Staff told us they felt they could approach the manager for advice. They knew and understood their responsibilities and the importance of their role. Regular staff meetings were held to ensure staff were up to date. Staff we spoke with confirmed they were able to discuss matters with the manager who held an 'open door' policy.
People and their relatives said they were consulted about their views and they completed satisfaction questionnaires. Residents meetings were held and relatives were invited to attend these meetings.