7 August 2014
During a routine inspection
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at. We used the evidence we collected during our inspection to answer five questions.
Is the service safe?
Risk assessments were in place for things such as moving and handling and medication. Control measures had been put in place. This meant that people's needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. A relative we spoke with said, 'X seems happy, we have no concerns.' A person we spoke with said, 'This home is very good, I feel safe and would like to stay here.'
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Documented procedures were in place for the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made. Training for the Mental Capacity Act was being planned for all care staff. This meant that systems were in place to safeguard people as required.
People were protected against the risks associated with medicines. Medication records were accurately maintained. Only staff that had been trained administered medication.
Recruitment procedures were in place. Appropriate checks were undertaken before staff started work. Staff received induction, shadowed experienced staff and completed mandatory training. The registered manager told us that most staff had worked at the home for a number of years. One person said, 'I am looked after, the staff treat me with respect.'
On a previous inspection we found that we could not be certain that people would always be protected from the risks of unsafe or inappropriate care and treatment because information about them was not accurately maintained. During this inspection we saw evidence that improvements had been made. Care plans were written in a person centred way and new daily journals had been introduced.
Is the service effective?
People experienced care and support that met their needs. People told us how they were supported. The registered manager told us they worked with other agencies to ensure people's health and social care needs were met. One person told us that they were supported to attend hospital appointments. A social worker who was visiting said, 'The service is very professional and on the ball. They follow processes.' People confirmed that they were involved in decisions about their care. This meant that people received care in the way they wanted.
Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.
Is the service caring?
People were supported by kind and considerate staff. Staff we spoke with told us how they supported people. People and relatives confirmed staff were caring, respectful and polite. One person said, 'Staff ask me if I want help with my medicine.'
People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain their independence. One person said, 'The food is excellent, we are given choices.' This meant people's diversity and individuality were promoted and respected.
Is the service responsive?
People were treated with respect and dignity by the staff. Care plans had been developed to reflect people's individual care requirements and preferences. They identified people's needs and were reviewed annually or when there was a change in need. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. A relative said, 'X seems very happy here.'
We observed the service responded quickly to meet people's needs and ensured people's safety and dignity was maintained. For example, call bells were responded to quickly. This was confirmed by people we spoke with. People and their relatives confirmed that they were given choices and encouraged to express their views.
People told us they would speak to the manager if they were unhappy about anything. We saw a copy of the complaints procedure was available to people and their relatives. The registered manager told us there had been no complaints since the last inspection.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. However, some staff felt that other agencies and professionals did not always listen to their views. Staff told us they were supported to complete refresher training. Some staff felt that additional training opportunities were not as good as they used to be. Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. People we spoke with were positive about the service and care they received
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. People had access to a copy of the complaints procedure. This reduced the risks to people and helped the service to continually improve.
The service had a quality assurance system in place. Audits were undertaken regularly. The registered manager showed us monitoring reports that they supplied to the provider. Analysis was undertaken and action taken where necessary. This meant the quality of the service was able to continually improve.