The inspection was completed by a single adult social care inspector. On the day of the inspection the service was provided to 59 people. As part of this inspection we spoke with the four people who used the service and one relative. We spoke with the registered manager, the chef, a member of domestic staff, a nurse and four members of care staff. We also spoke to a visiting professional. We sampled people's care records and reviewed records relating to the management of the home.Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at. We used the evidence we collected during our inspection to answer five questions.
Is the service safe?
Risk assessments were in place for things such as moving and handling, skin integrity and falls. Control measures had been put in place. This meant that people's needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. A relative we spoke with said, 'I feel safe here, I am happy with my room, I can personalise it and I can have lunch in my room.' Another person said, 'Yes, staff complete my records.' A relative said, 'I am involved in any changes to X's care or medicines. If there is a problem they always notify a relative.'
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Documented procedures were in place for the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made. Staff had also had training in the Mental Capacity Act 2005. This meant that systems were in place to safeguard people as required.
The service was safe, clean and hygienic. People we spoke with were able to confirm their rooms were cleaned daily. We found the home to be clean and odour free. We saw evidence that flooring in the kitchen was due to be repaired or replaced. We saw that cleaning schedules and checklists had been completed. Vacant rooms were deep cleaned. This meant that the provider took action to maintain a clean hygienic environment and reduce the risk of spread of infection.
On a previous inspection we found that people were not always fully protected against the risks associated with medicines because arrangements in place to manage medicines were not always followed. During this inspection we found that arrangements in place were being followed. Medication records were accurately maintained. Only staff that had been trained administered medication.
Is the service effective?
People experienced care and support that met their needs. People told us how they were supported. The registered manager told us they worked with other agencies to ensure people's health and social care needs were met. One person said, 'The Doctor comes to see me whenever I need him.' A visiting professional said, 'The services attention to detail is very good.' People confirmed that they were involved in decisions about their care. This meant that people received care in the way they wanted.
Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.
Is the service caring?
People were supported by kind and considerate staff. Staff we spoke with told us how they supported people. People and relatives confirmed staff were caring, respectful and polite. One person said, 'Yes staff are caring, I see the manager every day.'
People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain their independence. One person said, 'Some staff are very good, The food is excellent, we are given choices.' This meant people's diversity and individuality were promoted and respected.
Is the service responsive?
People were treated with respect and dignity by the staff. Care plans had been developed that took into account people's changing needs and wishes. They identified people's needs and were reviewed regularly or when there was a change in need. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. A relative said, 'We have no complaints, X is very happy here.'
We observed the service responded as quickly as it could to meet people's needs and ensured people's safety and dignity was maintained. However, when staff were busy taking people to the bathroom a few people had to wait until a member of staff was free to attend to them. A relative said, 'They could do with more staff.' People told us that staff responded to call bells as soon as they could. People and their relatives confirmed that they were given choices and encouraged to express their views.
People told us they would speak to the manager if they were unhappy about anything. We saw a copy of the complaints procedure was available in people's rooms. The registered manager told us there had been no complaints since the last inspection.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. This was confirmed by a visiting professional. Staff told us they felt supported and that the training opportunities were good. However, most staff said that they could do with more staff. Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. People we spoke with were positive about the service and care they received. One person said, 'Yes I think it is well led.'
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. People had access to a copy of the complaints procedure. This reduced the risks to people and helped the service to continually improve.
The service had a quality assurance system in place. Audits were undertaken regularly. The registered manager showed us monitoring reports that they supplied to the provider. Analysis was undertaken and action taken where necessary. This meant the quality of the service was able to continually improve.