We spoke with two people who used the service, the registered manager, a staff member and two family members of people who used the service during this inspection. We also looked at the quality assurance systems. This helped answer our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found.Is the service safe?
People were treated with respect and dignity by the staff. Two people who used the service told us, "They are honest and I trust them. I feel safe" and "I trust them and feel safe with them". We saw in one plan of care that staff were directed to only aid a person if he required it to help protect his privacy and dignity. The training matrix and staff files showed staff had been trained in safeguarding topics and there was a whistle blowing procedure for staff to report any issues with confidence. We saw that there were effective systems on the prevention of or reporting possible abuse.
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. Two people who used the service said, "We can get hold of the service in an emergency. We can contact them when we want" and "I can contact the manager if I need anything and she sorts it out". We saw that managers conducted audits on concerns, incidents, compliments and complaints to help improve the service. We noted no complaints had been made despite the regular contact with people who used the service or their families to ask their views.
We looked at documentation which showed the care agency looked at any hazards to care and treatment and conducted risk assessments to help protect the health and welfare of people who used the service and staff. We saw that electrical and fire equipment had been maintained in the office. The checks helped keep people safe from possible harm.
Is the service effective?
People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People who used the service told us, "They write about me after every visit. They put down if there are any changes. We read it and it is accurate" and "They write in my care plans and involve me in the plan and any changes. I read what they have written and it is what they have done. The care I get is the care I require". A family member said, "They tell us what they write about him in the care plan. They ask what we want from the service". Quality assurance survey forms showed us that people were satisfied with the service they received.
People who used the service were supported to make decisions and helped with their finances if it was required. People told us they were involved in their care and support.
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
Staff we spoke with and from the documents we looked at we saw that staff had been trained in mandatory topics such as health and safety, first aid, food hygiene, fire awareness, moving and handling, infection control and the administration of medication. A person who used the service told us, "My main carer is good and very professional although they are all well trained and know what they are doing". A family member said, "We get the same staff and this works well because they know him. They seem to be well trained. They always use the hoist and know what to do for him". Staff were sufficiently trained to deliver effective care.
We saw that the office was well equipped to run effectively.
Two people who used the service said staff were "reliable" and came on time. They stayed the amount of time allocated for their tasks. One person said her main care worker went beyond what she was required to do.
Is the service caring?
Two people who used the service told us, "The staff are pleasant and explain any care they give to my husband. They tell him what they are going to do" and "I have two excellent care staff. I have quite a new one and I rang social services today to say how much I like her and would like her to continue". People were supported by kind and attentive staff.
People who used the service, their family and friends were asked about their views of the care home. This included a bi-annual survey which we looked at and saw the positive results. The provider used the comments and surveys to improve the service.
People had what the service called 'personal care plans'. The plans contained detailed past histories. The information gave staff an insight into people's likes and dislikes and their wishes. We saw that staff were careful to meet the ethnicity of people who used the service by providing suitable staff who matched them well. Some staff were aware of people's religious or ethnic care needs and provided care sensitive to their needs. Care was provided in accordance with people's diverse needs, which included any religious or ethnic needs.
Is the service responsive?
The service supplied people with their out of hours telephone numbers. All the people and the relatives we spoke with were satisfied with the availability of the service in an emergency. One person was delighted her carer had "Given me her own number to call if I ever need to urgently".
The service conducted surveys and contacted people who used the service on a regular basis to ensure they received the care they needed.
The service held regular staff meetings to gain and react to their views. Staff were sometimes subject to spot checks to ensure they were delivering the care they were supposed to. Plans were regularly updated to make sure any changes were recorded and the plans amended.
Is the service well-led?
We saw that the service worked well with other agencies and organisations. We saw that meetings with professionals were arranged if it was necessary.
The service had quality assurance systems in place and records showed that people who used the service and other organisations were happy with the service provided. Staff we spoke with felt supported. A member of staff said, "I think we are well trained and supported. The agency is good to work for. I like my job". As a result the quality of the service was continually improving.
We saw that staff were well trained and understood their roles. Staff also had access to a copy of the Skills for Care codes of conduct. This document guides staff on how to lead other staff and what is expected of each individual. This helped to ensure people received a good quality service at all times.