This inspection took place on 7 March 2017 and it was unannounced.The Headington Care home is registered to provide accommodation for up to 60 older people living with dementia who require nursing or personal care. At the time of the inspection there were 59 people living at the service.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager worked closely with the deputy manager.
At the last inspection on 27 January 2016, we asked the provider to take action to make improvements and ensure staff were deployed effectively during meal times, staff engaged with people meaningfully and offered person centred care and ensured people received meaningful activities and stimulation. At this inspection on 7 March 2017, we found these actions had been completed. However, we still have some concerns.
People had varied dining experiences. Some people were not always supported in a timely manner during meal times. Some staff prioritised other tasks to supporting people having meals.
People who were supported by the service felt safe. The staff had a clear understanding on how to safeguard people and protect their health and well-being. People received their medicine as prescribed. There were systems in place to manage safe administration and storage of medicines.
The Headington Care home had enough suitably qualified and experienced staff to meet people's needs. People told us they were attended to without unnecessary delay. The provider had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.
People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where risks to people had been identified, risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe.
Staff received adequate training and support to carry out their roles effectively. People felt supported by competent staff that benefitted from regular supervision (one to one meetings with their line manager) and team meetings to help them meet the needs of the people they cared for.
The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of MCA. The registered manager and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety.
Staff treated people with kindness, compassion and respect and promoted people’s independence and right to privacy. People received quality care that was personalised to meet their needs.
People were supported to maintain their health and were referred for specialist advice as required. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible. End of life care was provided in a compassionate way.
Staff knew the people they cared for and what was important to them. Staff appreciated people’s unique life histories and understood how these could influence the way people wanted to be cared for. People were actively involved with the local community. People were encouraged and supported to engage with services and events outside of the home. Staff supported and encouraged people to engage with a variety of activities and entertainments available within the home. Activities were structured to people's interests and people chose what activities they wanted to do. The environment was designed to enable people to move freely around the home.
Feedback was sought from people and their relatives and used to improve the care. The provider had systems to enable people to provide feedback on the care they received. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.
Leadership within the service was open and transparent at all levels. The provider had effective quality assurance systems in place.
The registered manager informed us of all notifiable incidents. The registered manager had a clear plan to develop and further improve the home. Staff spoke positively about the management support and leadership they received from the registered manager.