The purpose of the inspection was to 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. The summary is based on our observations during the inspection, discussions the staff supporting them and looking at records.
Many of the people living in Wraxall Road had a profound physical disability and therefore did not communicate verbally. In order to understand their experiences we observed staff interactions with people over the course of our inspection.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
Care plans were person centred and detailed the individual's personal preferences and information to keep them safe. Risk assessments were seen covering all areas of daily living. This included support with moving and handling, personal care, accessing the community and eating and drinking. This meant that staff had guidance to support people safely.
Systems were in place to make sure that the registered manager and staff learnt from events such as accidents and incidents. This minimised the risks to people and helped the service to improve and ensure people's safety.
We found that the home was safe, clean and hygienic ensuring that people were protected from the risks of cross infection. Checks were completed on the environment to ensure they were safe and any risks were minimised.
Staff received suitable training to enable them to support people safely and understand different people's needs including supporting people with a physical disability.
Staff were observed supporting people appropriately with moving and handling. Staff had suitable equipment to safely support people with a physical disability. This included moving and handling equipment and specialist baths. Staff had received moving and handling training providing them with the knowledge to support people safely.
Is the service effective?
People's health and care needs were assessed and a plan of care was put in place. Staff were aware of the needs of the individuals living in the home enabling them to support people effectively.
We saw that people received the care set out in their care plan and people received the support that they needed.
Two people using the service told us they were happy with the care and support they were receiving. Relative surveys indicated that they were happy with the service being provided, their relative's needs were being met and they were kept informed of any changes.
Is the service caring?
We observed staff meeting the needs of the people they were supporting. Two people told us they were happy in the home. They told us that they were going out with staff to the theatre and out for lunch. Both of the individuals knew who they were going out with and they were looking forward to their trips out. It was evident they had been informed about who was supporting them.
We saw that staff spoke to people in an appropriate manner and they were attentive to their needs.
People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People were supported by other professionals including speech and language therapists and physiotherapists. Referrals to other health professionals had been made and their recommendations were included in the plan of care for the person.
Care files included information about how the staff were supporting people with their health care needs and staying healthy. People were registered with a GP and had access to a dentist, chiropodist and optician. Where people's needs had changed, care plans had been reviewed and amended.
Specialist bathing equipment was available to support the staff in providing personal care to the people living in the home. This demonstrated that the service had suitable equipment to respond and assist people with a physical disability.
Is the service well-led?
There was a manager in the service that was registered with the Care Quality Commission.
The service worked well with other agencies and services to make sure people received their care in a joined up way.
Staff told us they were clear about their roles and responsibilities. Staff received regular training to enable them to fulfil their roles and this was kept under review. However, the frequency of supervisions for staff was not in accordance with the policies of the organisation. This meant that staff may not be receiving suitable support and guidance in respect of their roles.
The service had a quality assurance system in place. The records that we looked at evidenced that where shortfalls had been identified they had been addressed. However, we saw that the provider's arrangements to visit the service every two months were inconsistent. This meant that the provider quality monitoring was compromised and there was a risk that the quality of the service may deteriorate as shortfalls in the delivery of care may not be identified.