An adult social care inspector carried out this inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
This is a summary of what we found:
Is the service safe?
People felt safe at the home and with the staff who supported them. People we spoke with told us that there were enough staff to meet their needs. One person said: 'I certainly feel safe here. I feel very safe. I haven't found anything to worry about. The staff shut up at night and lock up. Staff come when you ring the buzzer. If you don't feel well the supervisor is straight up.'
There were systems in place to ensure the safety of the building and any equipment used. There were regular health and safety checks including checking the fire alarm system and hot water temperatures. Equipment was regularly checked by staff at the home and serviced by outside contractors.
Staff we spoke with were aware of the Mental Capacity Act 2005 and how to support people who were unable to make decisions for themselves. Staff were able to tell us about how they had involved other people in making decisions when someone lacked the capacity to make a decision for themselves.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. While no applications have been submitted relevant staff have been trained to understand when an application should be made, and in how to submit one. People's rights were therefore properly recognised, respected and promoted.
Is the service effective?
People said they received effective care and support. We saw the care plan for one person who had developed pressure damage. The records showed the wound had healed. Staff continued to provide preventative care because the person remained at risk of further skin breakdown.
People told us they continued to make choices about all aspects of their day to day lives and to enjoy daily living as much as possible. One person preferred to do as much for themselves as they could. They told us "I feel free here. I came here from hospital four years ago and I make the most of it. I have a frame and walk round the garden. Sometimes I get into town. The staff encourage us. "
People told us they were able to make choices about what time they got up, when they went to bed and how they spent their day.
Is the service caring?
People told us staff were kind and caring. They commented on the patience and kindness of the staff who supported them. One person told us: 'They are excellent. They could not be kinder.' Another person said: 'They ask me if I am happy. They are so very good. They really do seem to care about us.'
People we spoke with felt their privacy and dignity was respected. Throughout the inspection we heard and saw staff treating people with respect, asking their views and responding politely to all requests for assistance. One person said: 'All the girls are gentle and kind.'
A member of staff told us this was 'a good place to work' and felt people's best interests, care and welfare were considered to be the main focus of the home.
Is the service responsive?
People received care that was responsive to their individual needs. People we asked were very satisfied with the care and support they received.
The home had systems in place to plan and monitor people's individual care and support. Each person had their needs assessed before a placement was offered to ensure the home was able to meet their needs. From the initial assessment a care plan was written to identify how the person's needs would be met.
Staff had a very good knowledge of people's healthcare needs and were able to tell us about how they monitored and treated individual needs.
Is the service well led?
There was a registered manager in place who had many years' experience of caring for older people. They were very knowledgeable about the needs of people in the home and led the staff in providing good standards of care.
There was a staffing structure in the home which gave clear lines of accountability and responsibility. There was always a senior member of staff on duty to offer advice and support to less experienced staff.
There was a complaints policy in place. We saw that any complaints made were fully investigated and responded to. People we spoke with told us they would be comfortable to make a complaint if they were not happy with any aspect of their care. One person said: 'I am satisfied with everything but if I wasn't I'd complain. I know they would listen.'
People's views were listened to and action was taken to make sure suggestions were put in place where appropriate.