The summary is based on our observations during the inspection, speaking with people who used the service, and the staff who supported them. We spoke with two staff members and two people who used the service. We also looked at five care records in detail and other documentation.We considered the findings of our inspection to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found-
Is the service caring?
We saw that staff were kind and attentive and encouraged people to be independent.
During our inspection we observed staff spoke with people on an individual basis and understood their particular needs.
We spoke with two people who used the service they told us, staff were respectful and always asked them what they wanted doing before carrying out a task.
Is the service responsive?
We saw that people's individual physical, mental and social care and support needs were assessed and met. We saw evidence that care plans had been discussed with people. This also included people's individual choices and preferences as to how they liked to have their care provided. For example, care plans detailed how people liked to have their meals.
We observed people's consent had been obtained on issues such as provision of care and support with medicines.
Where people's needs had increased or changed we observed care had been changed to meet those needs.
One person we spoke with told us that after a hospital admission they had received support from the provider to meet their needs in a timely and appropriate manner.
Staff we spoke with told us if people required additional support on an ad hoc or regular basis they were able to provide it.
Is the service safe?
Risk assessments regarding people's individual care needs, for example falls and mobility were carried out and measures were in place to minimise these risks.
The home had policies and procedures in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) in place. Mental Capacity Act (2005) and Deprivation of Liberty Safeguards are laws protecting people who are unable to make decisions for themselves.
When we spoke with the registered manager they gave us an example of when they had carried out an assessment of capacity to ensure a person received care in their best interest.
Staff were able to tell us what they would do if there was an accident or incident. They also said that there was always a manager about to ask for assistance if required.
Is the service effective?
Our observations found that members of staff knew people's individual health and wellbeing needs. Staff told us about situations when they required more support for people and they were able to obtain this, for example, if a person required more time for support due to illness
We observed care plans had been updated to reflect people's changing needs and where people had short term needs due to illness care plans were in place to ensure these were met.
Where people had specific physical issues such as diabetes we saw their care plans reflected this.
Is the service well led?
Staff said that they felt supported and trained to safely do their job. They told us they felt able to raise issues with the managers.
We saw staff had received supervision and had had opportunity to raise issues at their supervision such as additional training needs. Staff had not had appraisals in the last year. Appraisals are used to provide support to staff and identify ongoing training needs. They are usually held on a yearly basis. The registered manager told us that they were reviewing the format for supervision and appraisal and would be planning the appraisals for this year.
The manager told us they were in the process of revising the appraisal arrangements and setting these up with staff.
Quality assurance arrangements and checks were in place and people were listened to. For example a survey had been sent out to people in February 2014. There were also arrangements in place to enable people to speak with managers on a regular basis about the service provision.
The provider did not have a formal arrangement in place for observing and recording care practices. They told us they would address this issue.
Records were accurate and reflected the care people required. The provider had put in place arrangements to ensure records reflected the care people required and that people had agreed to this care.