Archived: Yew Tree Cottage

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service and the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service caring?

People were supported by kind and responsive staff. Most of the staff had worked with people for a long time and knew them well. We saw that relationships were positive. Staff showed interest in people and what they were saying. We saw that staff were respectful in their interactions with people.

We saw that a lock had been removed from the door to the downstairs toilet and shower room. We were told that this had been done intentionally as a safety measure. A hole had been left in the door which meant there was a lack of privacy for people who used this facility. The absence of a lock and the hole in the door did not respect people's privacy or uphold their dignity. We have asked the provider to tell us what action they are going to take to address this to ensure that they comply with the law in respect to upholding privacy and dignity.

Is the service responsive?

We saw staff working in a flexible way to support the needs of people who used the service. We saw that people were supported to access relevant health services to ensure that their health needs were met and that staff responded to people's health needs in an appropriate and timely manner.

We saw from records that residents meetings were held regularly and that people discussed activities that they would like to pursue. We heard that staff supported people to access a range of activities in the local community including going on holidays which people told us they enjoyed. Two vehicles were provided to ensure that people could make use of community facilities more easily.

Is the service safe?

People told us they felt safe and appeared to feel comfortable in the company of staff.

Safeguarding procedures were in place but not all staff understood their role in safeguarding the people they supported or know where to find the safeguarding policy and procedure. This increased the risk of harm to people. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to safeguarding people from the risk of abuse.

The provider had a mental capacity policy which covered the Deprivation of Liberties Safeguards. We found that, although training had taken place some staff were unclear about how the Mental Capacity Act 2005 and the Deprivation of Liberties Safeguards related to the people they support.

There was a system in place to make sure that the manager and staff learned from events such as accidents and incidents, and complaints. This meant that the service was able to learn from adverse events to reduce the chance of them reoccurring.

Is the service effective?

People told us that they were happy with the care that had been delivered and that their needs had been met. One person commented, 'I absolutely love it. It is fantastic. I don't want to live anywhere else. Staff help me with things and they are very kind.'

It was clear from our observations and from speaking with staff, that they had a good understanding of the people's care and support needs.

People were involved in many aspects of running of their home, and were supported to access a wide number of activities in the community and within day services.

We saw that the service needed to make improvements to how they supported people to maximise their involvement in other areas. For example, although care plans showed that people had been involved in discussing their needs and preferences, people we spoke with were not able to recall whether they had a care plan. This suggested to us that they had not been involved in the process in a way that was meaningful to them. We found that care plans and other important information was not presented in a format which took account of people's communication needs. This meant that people could not access information independently which meant that there was a risk that they did not have as much opportunity to make informed decisions as possible. This did not support people to maximise their independence or involvement in their care.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to giving people access to information and maximising their independence and involvement.

Is the service well led?

We saw that care plans and risk assessments were regularly reviewed. This ensured that people received care that was appropriate to their current needs.

Staff told us they felt well supported. We saw that good systems were in place to support staff to communicate well with each other on shift. This helped to ensure that people received consistent care.

Records showed that staff received supervision and appraisals, although not as regularly as the providers policy required. Training opportunities for staff were good although we noted that some training may not have been of a sufficient quality to ensure that all staff had an appropriate level of knowledge in some key areas such as safeguarding and the Mental Capacity Act 2005.

The provider had effective systems in place to monitor the quality of the service. We saw that people who used the service and their relatives were asked for their views about the service through an annual quality monitoring questionnaire.

We observed laughter and friendly banter between staff and people living in the home during our inspection.

Care records we looked at were well written and included risk assessments to allow people to enjoy their life.

Medication procedures and records were well managed although we noted that additional medication had not been signed in for one person.

Recruitment records were well managed and all the required information was available to ensure the safety of people who live at Yew Tree Cottage.

Staffing levels were adequate to meet people's needs and the staff felt well supported and received appropriate training to ensure their skills and knowledge remained up to date and in line with best practice. Refresher training had just taken place when we arrived at the home.