A single inspector carried out this inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: 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, speaking with people using the service, their relatives, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People living in the home were treated with dignity and respect by the staff that supported them. We received a number of positive comments, a care worker said "this is their home, they decide what they require from us" and a person living in the home told us "it's nice here". One relative told us 'the staff are very good, I can't praise them enough'.
Staff we spoke with were able to tell us what action they would take if they saw abuse taking place and where to find the correct contact information and procedures. One staff told us 'we have a job to do and it's our duty to report any type of abuse."
Staff carried out a range of health and safety checks to ensure people were kept safe. Records showed that fire drills were carried out and people had their personal emergency evacuation plans.
Where there were risks associated with people's health, these were assessed and appropriate support plans put in place. For example, we saw that a person in the home who needed help moving had very detailed instructions for staff on how it was done. There were also photographs with the instructions to help ensure the person was moved safely by the staff.
Is the service effective?
People living in the home and their representatives were involved in the care planning and review process. Annual care reviews involved the person living in the home and they contributed towards their agenda. This helped ensure that support was person centred and reflected the needs of each individual. One relative had just attended a meeting with staff and a social worker to discuss an aspect of a person's health, told us 'the staff phone me or email me regularly and I attend the annual reviews'.
Staff told us that communication was good in the home, so that staff would be aware of any particular issues relating to individuals. One way information was discussed was at handovers.
Staff confirmed they had regular supervision and the records showed that the supervisor held meaningful discussions to ensure staff understood their role and responsibilities. A member of staff told us 'I love my supervision; it's great to put my point across'.
Is the service caring?
People that we observed during our inspection reacted positively towards staff. We saw a lot of non -verbal communication between people and staff, playing little games between themselves which brought smiles to people's faces. One person told us 'it's nice here' whilst a relative said 'I've never had any concerns'.
We noted that staff were providing personal care in bedrooms with the door closed. This practice of respecting a person's privacy was confirmed by a person living in the home and their relative who said 'the bedroom doors are always kept closed'.
We made observations of people receiving the support they needed, in line with their care plan. For example, we saw that one person was sat out as instructed in the care plan whilst staff spoke to another person with phrases which helped the person remain calm.
Is the service responsive?
We saw that the service worked well with other healthcare professionals. For example, one person had recently had a visit from a speech and language therapist. We saw from the care records that a GP and a dentist were contacted because staff had concerns about a person's health.
The way people expressed their likes and dislikes had been recorded so that staff could understand people's wishes. Relatives told us that staff contacted them on a regular basis to discuss any changes to care and support. One relative told us "I get monthly news letters and weekly emails which means I know what is happening".
People could make choices. We regularly heard staff asking people to make a choice. One staff asked a person "are you going for your coffee? Shall we go into the lounge together'?
We saw that accidents and incidents were recorded, analysed and action taken to reduce the chances of it happening again. This provided opportunity to identify any learning points and put any required action plans in to place.
Is the service well led?
We saw there were systems in place to monitor the quality and safety of the service. This included gathering the views of people living in the home and their relatives. People had opportunity to attend monthly home meetings and the minutes showed that all the people at the meetings were asked for their view and their responses recorded.
The home received regular visits from the representatives of the registered provider. One of the external manager's reports which we viewed provided an overview of their visit, an evaluation and recommendations.
Any accidents and incidents that occurred in the home were recorded and analysed on a monthly basis. We saw evidence of where action was taken to reduce the risk.
The registered manager explained how the service worked hard on selecting staff which were suitable for meeting the needs of people using the service. The recruitment records showed the detailed interview questions used to select the right staff.
The records which we asked for were made readily available for us and the registered manager could provide the evidence which we requested to see. This showed that the registered manager was fulfilling her role and responsibilities to manage the service effectively.