Two inspectors carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe? is the service effective? is the service caring? is the service responsive? and is the service well-led? Below is a summary of what we found. The summary is based on our observations during our inspection, speaking with people using the service, their relatives, and staff, and looking at records.The detailed evidence supporting our summary can be read in our full report.
Is the service safe ?
People and their visitors told us they felt safe. There were effective arrangements in place for staff to identify the possibility of abuse, prevent it from happening, and respond appropriately to any allegation of abuse. We observed that appropriate arrangements were in place to manage medicines safely and effectively.
Recruitment practice was safe and thorough. There was, however, limited evidence that people's care needs were taken into account when making decisions about the number, skills and experience of staff required when setting duty rotas.
There were some arrangements in place to deal with foreseeable emergencies, however these did not ensure that equipment and emergency medicines were readily accessible or that there were on-going equipment checks and systems to replace used items.
There were ineffective arrangements in place to protect people from the risk and spread of infection.
Is the service effective ?
People's health and care needs were assessed and there were care plans in place. There was limited evidence of people being involved in assessments of their needs and planning their care, or that specialist and expert advice was sought and acted upon. Some of the care plans had not been reviewed or updated regularly. It was therefore not possible to confirm all people's needs were being met. Staff did not have the opportunity to participate in on-going learning and development activities in some relevant topics, although they had regular supervision and appraisal.
Is the service caring?
People and their relatives told us that they were generally satisfied with the care provided within the home, that staff were kind, approachable, and kept them informed. We found staff acted in accordance with the wishes of people who used the service. Where people were able, they gave give valid consent to examination, treatment, care and support. Staff knocked on people's doors, explained care to people, gained their permission to provide care and treatment, and to receive visitors.
There was no designated person to co-ordinate activities for people using the service within the home, and no evidence that planned activities were available on a daily basis, or that they were evaluated.
Is the service responsive?
We found staff understood people's individual communication methods, enabling choice in their daily lives. We saw some examples of where staff worked collaboratively with other health and social care professionals and agencies, ensuring people received care in a co-ordinated way. People, their relatives and staff were all familiar with the processes to feedback comments and concerns about the service. However, we saw limited evidence that learning from feedback had taken place or that it had been acted upon.
Is the service well-led?
People, visitors and staff told us that they felt supported by managers, that managers were approachable and accessible, that communication was good, and that they felt listened to. There was limited evidence of an effective quality assurance system to identify, assess and address risks relating to the health, welfare and safety of service users and others who may be at risk. The quality assurance systems did not make sure that the knowledge and experience of people, or staff, was properly taken into account and acted upon or that shortfalls were appropriately addressed.