27 June 2014
During a routine inspection
Below is a summary of what we found. The summary is based on our observations during the inspection. We spoke with nine of the 33 people who used the service, four staff and the registered manager.
We found that the provider had made the necessary improvements with respect to supporting people with their needs and ensuring they received their medicines when they needed them. We saw care records had been improved to show how people’s needs should be met safely
Is the service safe?
We saw that plans were in place which identified people’s needs and any risks they faced to their safety or health. The plans included information about how to reduce risks such as falling or fragile skin, to help keep people safe.
We saw that monitoring records were in place. These reflected that care interventions were consistently carried out for people with fragile skin, or people at risk of not eating or drinking enough. This meant people had the care they needed to avoid further risks.
Effective systems were in place to ensure that people’s medicines were managed appropriately. People had their medicines on time and in a way they preferred or needed. This was because plans detailed how people’s medication should be provided. We saw systems were in place to guide staff in the safe handling of medicines. Checks had been made on staff competencies to do this safely. The manager had robust weekly checks to ensure there was a supply of people’s medicines and to check records were completed properly. One person told us, “I do sometimes need pain killers and the staff provide these”. We saw people had plans in place to ensure they had safe and effective pain management.
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. For example staff understood how to keep people safe who were at risk of leaving the building. We saw a ‘missing persons’ procedure’ was in place and staff were aware of those people who needed their whereabouts to be monitored to keep them safe. This meant that lessons had been learned from previous incidents.
We saw that checks had been carried out on staff before they commenced working. The manager understood and had used disciplinary action to make sure that unsafe practice is identified and people are protected.
Is the service effective?
People had their needs and wishes assessed and had been involved in choosing how they were supported.
Arrangements were in place so that people had access to health care professionals so that their medical needs could be met. People had the equipment they needed to manage such things as fragile skin.
We saw that staff had training and support to meet the complex needs of people to ensure they met their needs effectively. The manager had reviewed staff training, observed care practices and provided guidance to staff to ensure staff gained the skills and used them effectively in meeting people’s needs. A staff member told us, “We have guidance in meetings, written records, handovers and we are observed. I think we now do a much better job in meeting people’s needs”.
Is the service caring?
We spent time in the communal areas observing staff interactions with people. We saw they made time to chat to people and checked regularly that they were comfortable.
People told us that they were happy with the care they received. One person said, “I get my privacy and staff are really good at helping me when I need it”.
We saw that staff protected the dignity of people by ensuring they were observant of such things as ensuring people wore their own clothing and were dressed appropriately.
People said their preferences and interests were being met. We found this information was recorded and care and support had been provided in accordance with their wishes. We saw staff knew people’s support needs as well as their personality, and took an interest in them. One person said, “He’s lovely always chatting to me, he’s a nice bloke, makes sure I’m ok”.
Is the service responsive?
We saw that people attended regular meetings to talk about things they wanted to do. We saw examples of where people’s comments had been addressed by staff, such as changes to menus, arranging trips out and bringing in community amenities such as the ice cream van weekly and a visit from the armed forces. Staff had supported people to enjoy activities they were interested in. One person told us, “It’s so refreshing to do exciting things, I’m not too old you know”.
We found that the manager had worked with other external agencies to ensure people’s needs were responded to properly.
We saw that staff were well informed of changes to people’s care needs. We saw there were systems to monitor accidents and incidents to identify how staff could improve responses.
Is the service well-led?
The service had a quality assurance system in place. We found the monitoring of the service had significantly improved. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and had been involved in carrying out audits. This meant staff’s understanding of standards had been enhanced and helped to ensure that people received a good quality service.
The manager told us they received good support from their management team and had no concerns about the operational running of the home. Staff told us they felt supported by the manager and had effective working relationships with their team.