A single inspector carried out this inspection on 25 July 2014. As part of this inspection we spoke with the deputy manager, the staff and we reviewed information given to us by the provider. We met and spent time the four people of the five people who lived at the home. They were not able to communicate with us. They appeared to be happy, relaxed and comfortable with the staff that supported them.Below is a summary of what we found. The summary is based on our observations during the inspection, observations of people using the service, the staff supporting them and from looking at records. We used the evidence we collected during our inspection to answer the five questions.
Is the service safe?
From our observations and the information we saw set out in care plans, policies, procedures and audits the provider's safety monitoring systems were robust. The staff showed that they had a clear understanding of their role in providing care and in safeguarding the people they supported. The staff demonstrated that they knew the people well and worked to provide the best possible level of care and support.
We saw evidence that when people lacked the capacity to make decisions on important areas of their lives, best interests, safeguarding and deprivation of liberty discussions had taken place.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw that all the people who lived at the home had current deprivation of liberty safeguards orders in place. All the records were correct and up to date with review dates in place.
The staff rotas showed that the management had taken people's care needs into account when making decisions about the number of staff required, the skills and experience staff would need. The night time staffing levels and on call system showed that the provider had taken steps to ensure the staffing provision was safe out of main hours.
There were systems in place to make sure that management and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This meant that people were benefiting from a service that was taking on board lessons learnt.
Is the service effective?
People's care needs had been assessed and detailed care plans were in place. There was evidence that people and their families were involved in the assessments of their needs and care plan reviews as much as possible.
The staff we spoke with and activity plans showed us that people were supported to participate in activities they enjoyed.
All care, activity plans and risk assessment were reviewed regularly. We saw evidence in care plans that the care provided was constantly adapted to meet people's needs.
We saw evidence that people were supported by a wide range of health and social care professional. This meant their health and welfare needs were being met.
Is the service caring?
We observed that the staff supported each person in a way which met their individual needs. The staff showed warmth and consideration. The staff showed respect and ensured people's dignity was maintained at all times
The staff we spoke with told us they were committed to provide a good caring service to support and look after the people so they could have a good life. They demonstrated that they were aware of potential risks, people's rights and their responsibilities
Is the service responsive?
We saw the care plans were person centred and contained detailed information about people's choices and preferences. We saw in the notes the information showed that each person was supported in an individual way which was adapted regularly to meet their changing needs. We saw that people's health and support plans were regularly updated to reflect people's changing health care needs.
There was evidence of regular support provided from external social care and health professionals. This meant that people's health and welfare was regularly reviewed and monitored.
The staff we spoke with said if they had any concerns, they could always talk with the senior staff, they would always listen and address anything they raised.
The staff said they received regular training which was very good and equipped them with the knowledge to meet people's support needs.
Is the service well-led?
The home had a clear management structure in place. The deputy manager and the staff we spoke with were knowledgeable about the people who used the service, changes to legislation and developments in care provision.
We saw that senior staff were always around to give advice and support. There were systems in place to provide feedback to staff about changes and developments.
The staff we spoke with said they understood their responsibilities around safeguarding people's welfare. They all said that if they witnessed poor practice they would report their concerns. They had worked with the people who lived at the home for some time and really enjoyed their work. They said that they felt they were supported and involved in the development of the service.