A single inspector carried out this inspection on 12 August 2014. As part of this inspection we spoke with the registered manager, deputy manager, three members of staff and we reviewed information given to us by the provider. We met the five people who lived at the home; they were relaxed and comfortable, and we saw that the staff had a good rapport with 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 in care plans, policies, procedures and audits, the provider's safety monitoring systems were robust. The training records showed that the staff received regular training on safeguarding. 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 recently had a mental capacity assessment and current safeguards orders were 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 and 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.
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 we looked at provided evidence that people were supported to live active lives and participate in activities within the community.
All care, activity plans and risk assessments 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 professionals. 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, consideration and respect for people. One member of staff we spoke with said. 'I like to do everything I can to support the people to live a good life. It is a good staff team here and we try to make it like a real home'. We saw that staff ensured people's dignity was maintained at all times.
We spoke with one of the people who lived at the home, they said. 'It is really good here. I am glad I came. I do a lot more now; I can go to church and yoga. We go to the disco, and it is great'.
The registered manager and staff we spoke with told us they were committed to provide a good caring service to support and look after people so they could have a good life. One of the staff we spoke with said, 'It is good to be able to have time to spend with the people, to show compassion in the care we give and ensure they are a person not a number'. The staff we spoke with demonstrated that they were aware of potential risks, people's rights and their responsibilities.
Is the service responsive?
We saw the care plans were focused upon the needs of the individual and contained detailed information about people's choices and preferences. The information showed that each person had an individual support plan 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 and that, they would always listen and address anything they raised.
We saw that staff received regular training which equipped them with the knowledge and skills to meet people's support needs.
Is the service well-led?
The home had a clear management structure in place. The registered manager and the staff we spoke with were very 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. One of the staff we spoke with said, 'There is always someone to ask and often they can help you to look at things from a different perspective'. There were systems in place to provide feedback to staff about changes and developments.
We were told by the deputy manager that the majority of the staff had worked with the people for some time. We observed that staff seemed to really enjoy their work. The registered manager told us about planned changes within the management structure which were taking place. These changes were being organised to minimise the effects upon the people who lived at the home.