Two adult social care inspectors carried out this inspection. This was a scheduled inspection in addition to checking improvements had been made following concerns identified at our last inspection of 19 November 2013. During that inspection we identified concerns with some areas of care and welfare in the home and concerns with records. As well as assessing whether improvements had been made in these areas, the focus of the inspection was to answer five key questions; Is the service safe, effective, caring, responsive and well-led?At the time of our inspection, 30 people were living at Dearne Valley Care Centre. We spoke with five people who lived at the home, four relatives, the regional manager, the home manager, one nurse, two care workers and a cook. We also reviewed records relating to the management of the home which included four care plans, audits, incident reports, meeting minutes and other relevant documentation.
Below is a summary of what we found. The summary describes what people we spoke with told us, what we observed and the records we looked at.
Is the service safe?
There were risk assessments in place where required for people using the service in relation to their support and care provision. These were reviewed and amended as necessary to ensure that risks were mitigated, whilst still allowing independence, to ensure people's safety in relation to their care and support.
Most people said they felt there were enough staff at the home. Comments included 'I've got a buzzer in my room, staff come to help me' and 'brilliant staff, they don't leave [my family member] all day, if he needs anything they will do it, no concerns at all'. However, one person and a staff member had concerns that staffing levels at night were not always sufficient.
Systems were in place to make sure the manager and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. Policies and procedures were in place to make sure unsafe practice was identified and people were protected. This reduced the risk to people and helped the service to continually improve.
People's care files were stored securely and records of people were reflective of their needs.
The home had policies in place in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS), and staff received training in this. One person at the home had a DoLS authorisation in place and other requests were in progress. The manager understood how to make the applications and in what circumstances they were required. This demonstrated safeguards were in place to protect people's welfare in line with relevant legislation.
Is the service effective?
People at the home were happy with the care they received and felt this was suitable for their needs. It was evident from speaking with staff they know people well and recognised what support people needed. People at the home told us, 'I need help to get about and they [staff] always help me out, they've all been good' and 'it suits my purposes'. One relative said, 'I feel my [family member] wouldn't be alive today if it wasn't for this home, they're brilliant, excellent care'.
People received a varied, well balanced diet and measures were in place to ensure people received adequate nutrition and hydration. Everyone we spoke with was complimentary about the food we saw that that any dietary requirements were taken into account by staff. One person said, 'the cook will send things up for me I can eat making sure there's nothing in I can't have'.
Is the service caring?
During our visit we saw care workers interacted positively and gave encouragement whilst supporting people. People said, 'It's been great here, the lasses are brilliant'. A relative we spoke with said, 'my [family member] physically looks a lot better (than where they were previously), staff are very friendly, very approachable, can't fault them'.
The three care staff we spoke with all demonstrated they had a detailed understanding of people's care needs. Each staff member was able to describe actions they would take in relation to specific events and incidents, in a way to ensure the peoples' safety and welfare.
Is the service responsive?
People's needs had been assessed before they moved into the home. Care plans were in place for each individual covering a number of areas including mobility, falls, weight, medication and capacity. Information was reviewed regularly and in response to any changes in needs. Updates and amendments were made where required. We saw contact with, and referrals to, other professionals had been made where necessary.
On the day of our inspection we saw people, where they were able to, moved freely about the home. One person spent time gardening in the outside area. Some people chose to spend time in their rooms. Staff told us they tried to spend time with people individually. Three relatives we spoke with told us this took place, one person saying 'staff spend one to one time with my [family member]'. People had opportunities for social and mental stimulation and to engage in meaningful activities.
Is the service well-led?
The home worked with other agencies and services to make sure people received their care in a co-ordinated way.
Staff, people and relatives had confidence in the new manager at the home who was being supported by the regional manager.
There was a detailed quality assurance system in place and records seen by us showed that identified shortfalls were addressed. This meant that actions to continuously improve were in place.
Customer satisfaction surveys were sent to people in the home and other stakeholders in order to formalise views of the home. Feedback was also sought by way of daily discussions and relatives and residents meetings.
Discussions on best practice, improved ways of working and incidents reviews were common throughout formal team meetings and informal discussions.