Archived: The Shires Care Centre

Is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Prior to our inspection we reviewed information we had received from the provider and from other sources. We used a number of different methods to help us understand the experiences of people using the service because some people using the service had complex needs. This meant they were not all able to tell us their experiences. The methods we used included looking at records and observation. We spoke with seven people who used the service to establish their views on the quality of service provided to them.

We also spoke with the acting manager, the qualified nurse on duty, three care support workers, the maintenance technician and a representative from the domestic team. We also looked at some of the records held in the service including the care files of five people. We observed the support people who used the service received from staff and carried out a partial tour of the building.

Is the service safe?

On the day of our inspection visit we found the service to be safe. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had been submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one. People we spoke with confirmed that they felt safe at the home and would speak to the manager or any of the staff if they had any concerns.

Is the service effective?

On the day of our inspection visit we found the service to be effective. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was present. We spoke with seven of the people who used the service. They were positive about the care and support they received. They told us they were well cared for and were encouraged to be as independent as possible. One of the people we spoke with said, "I am going to a disco tonight then watching football.'

Is the service caring?

On the day of our inspection visit we found the service to be caring. People we spoke with told us that they were happy with the care that had been delivered to them and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. One person said, "They are brilliant. We have a bit of fun and I think they really do care about me." Another person said, "The staff very good. Some are better than others but they're all good.'

Is the service responsive?

On the day of our inspection visit we found the service to be responsive. People living at the service told us they had plenty of chances to talk about the things that were important to them. One person said, 'We talk about what I want to do now and in the future.' Another person said, 'I tell the staff if I need something and they sort it out.' We spoke with people about their physical health needs and they all told us they saw their doctor if they needed to. They also told us they had access to a dentist and where necessary, had eye tests. Records showed that people received assessment and treatment from NHS health care professionals when required.

Is the service well-led?

On the day of our inspection visit we found the service to be well led. People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on, through an annual survey. People living at the service were offered support to complete surveys and advocacy services were used for people who required independent support. Staff we spoke with told us they felt well supported by the management team and enjoyed working at the service. One said, "I love this work. The acting manager is very approachable. We have regular, structured supervisions for us to discuss our work and annual appraisals. There is always someone available to help and advise.' Another staff member said, 'We have very good training and this helps a lot. You can never learn too much.'

When we visited on 12 August 2013, we found that some people were unable to access the activities they wanted or that were suitable for them. We had also received some information of concern about the care and treatment of some people at the home. So, this visit was to follow up on action taken since our last visit and to respond to the concerns we had received.

People's views of this service varied. Most people were satisfied with the service, but some had concerns about the lack of regular activities available to them. However, we saw that there had been an increase in the activities for the most vulnerable people, who had multiple disabilities affecting their communication. These people previously had very little stimulation or planned activity each day.

One person we spoke with said, "There's always something happening in here in the mornings." Another person said, "Everything is very nice, thank you." A visiting tutor told us, "We love coming here. Everyone is enthusiastic."

We found that, in general, the staff employed at The Shires followed the plans of care and did their best to ensure people's safety and welfare. Some staff provided additional individual support to ensure people took part in the activities they wanted.

We found that basic care and treatment was provided to ensure people's safety and physical health needs were met. Some activities were provided, but there were no clear plans about occupational needs or how to promote emotional wellbeing and meet people's individual needs. Some people were unable to access the activities they wanted or that were suitable for them.

People told us they felt safe. One person told us "They keep you safe here.' and another said, "They help me to feel safe. I can talk to staff if I feel worried."

Care staff told us they were supported with training to provide personal care in a safe way and there was a trained nurse on duty at all times.

A regional manager made regular visits to the home and people told us they had been consulted about the service and had given their views.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person said, "They help me to have my shower and they know I can do some things for myself, so they help when I can't reach."

People we spoke with told us they felt safe and that if they had any concerns they would speak to the manager or nurse in charge. One person said, "We would let people know if we saw anything of concern." Staff received training in keeping people safe.

Although two people told us they often had to wait a long time after they had used their call buzzers, there were enough qualified, skilled and experienced staff to meet people's needs and the manager was reviewing how long people were waiting.

Some people had recently been involved in preparing posters to give everyone information and people told us that they told the manager if they wanted something to be arranged differently. The regional manager completed a full report to monitor the quality of the service every month.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.