26 January 2018
During a routine inspection
The inspection took place 26 and 29 January 2018 and was unannounced. At our previous inspection in December 2015 the service was rated as Good in all areas. At this inspection we found that standards had been maintained and that efforts were being made in working towards achieving Outstanding.
People and their relatives spoke highly of the staff and management team. One relative said, “They treat everyone as they would their own, it is like one big family here.” This was echoed by the staff and registered manager, who also described the ethos of the service as being “family orientated”.
Relatives and health and social care professionals praised the staff team for their knowledge and skills, as well as how the team “go above and beyond” to support people. One relative said, “it gives a real peace of mind knowing mum is safe, happy and looked after here.”
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Where people had their liberty restricted, the service had completed the related assessments and decisions had been properly taken. Staff had been trained and understood the general requirements of the Mental Capacity Act (2005).
The service sought to offer holistic alternatives to medicines where possible. For example, exploring alternative methods to mild pain relief. There were also regular medicine reviews to prevent people from being over medicated. Medicines continued to be stored, administered and recorded safely. The service had built a good working relationship with the local health centre, as well as with visiting health professionals.
There were safe recruitment processes in place. Staff had the skills and knowledge to support people. Staff received up to date training and could request additional training where required, and every staff member had completed, or was in the process of completing dementia awareness training.
The activities programme was tailored to suit individual and group interests. We found that staff understood people’s interests and hobbies. Staff incorporated people’s interests into the social programme and supported people to maintain routines. For example, some people had enjoyed reading specific newspapers and magazines, and these were brought into the home; and one person was supported to the local shop to purchase their lottery tickets.
The activities coordinator understood and utilised the interests of individuals and groups of people to build community links and offer activities in and out of the service. Staff used a positive risk taking approach to support people to access their local community.
Care plans were very person centred and evidenced an understanding of what was important to the individual. These included information around the day to day decisions, such as how a person liked their hot drinks, but also the more complex decisions, such as information around their preferred end of life treatment and support. There was a person-centred culture within the service, with staff valuing each person as an individual.
Staff undertook training in end of life care and relatives spoke highly of the service their loved ones had received while living at the service. Staff understood the importance of dignity and empathy while providing end of life care.
Creative support methods were used to enable people to be involved in making decisions around their care. Staff and management used their understanding of the person when it came to trying new ideas and exceeded the expectations of social care professionals when doing so.