At our inspection we gathered evidence that helped answer our five questions. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with two people who used the service, two relatives, four staff and from looking at records.If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People we spoke with told us they felt safe living at the home. One person told us, "I feel safe here. I'm comfortable in my room. When I've used the call alarm they [staff] have always come quickly." Another person told us, "I'm safe here. I have a very pleasant room. I have my own things in it. I'm comfortable and safe." They added, "I've never seen anything that worried me. I know how I could make a complaint. If I had anything to say, I'd say it."
A relative told us, "I visit the home most days. It's safe here."
We observed how staff behaved with people. Staff protected people's dignity and spoke respectfully with people.
All staff we spoke with knew how to recognise and report signs of abuse. They were able to name the forms of abuse recognised in the Health and Social Care Act 2010. Staff knew how to identify and report concerns about people's safety internally within
the home but they told us they had lost the confidence to do so. Before our inspection we had received concerns from staff about the management of the home. Before and during our inspection, the local authority social services safeguarding team were investigating information they had received from staff and ourselves about the service.
A person who used the service told us, "It sometimes feels as if not enough staff are on duty, but I've never felt unsafe when it's been like that." Another person told us, "The girls [staff] are overworked." Staff we spoke with gave different feedback about their working hours. One told us they felt compelled to work long hours; another told us they wanted to. Most days the manager, a senior care worker and three care workers were on duty. At busy times of the day they were assisted by two other staff who had been trained to carry out care duties.
Staff we spoke with had only a basic awareness of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This is legislation that protects vulnerable people who are or may become deprived of their liberty through the use of restraint, restriction of movement and control.
Is the service effective?
Care plans included details of people's needs and information about how they were supported with their needs. People who used the service told us that they had been well cared for and supported. One person told us, "The care is very good. If I ask for anything the staff do it." Another person told us, "When I first came here I could hardly sit up but I can now because the staff have helped me." A relative was complimentary about the care provided. They told us, "It's a good home. The residents only need to ask and it's provided."
Until a few days before our inspection senior care workers had given one person insulin injections without proper training Staff we spoke with told us that they had not been supported through effective supervision or appraisal. Most staff we spoke with told us they had not been properly supported by the registered manager. One told us they had been placed into a senior position well before they felt ready for it.
People who used the service were complimentary about the staff and the care they received. People told us they felt comfortable about discussing their needs with staff.
Care workers we spoke with told us that they regularly referred to people's care plans.
Is the service caring?
People told us they were well cared for. One person told us, "The staff have always been nice to me." A relative told us, "It's a very friendly atmosphere. My [spouse] gets all the care they require." We saw that staff were polite with people. Staff offered reassurance and support to people when they appeared anxious. Staff took time to have meaningful conversations with people and provided people with interesting things to do. A person told us, "The staff have always treated me with respect. They're very good."
We saw that people were supported to be independent. People had chosen how they wanted to spend their time. Some people kept themselves occupied whilst others were supported with activities or provided with things that interested them, for example puzzles, newspapers or tactile objects that were clearly a comfort to them.
Relatives were able to visit people without undue restrictions.
In March 2014 the home was awarded a Dignity in Care award by Leicestershire County Council.
Is the service responsive?
People told us they were well looked after. One person told us, "The staff are very helpful. They are very nice and always there to help." Records we looked at showed that people had been supported with their personal care, nursing and health needs. However, we witnessed an instance where staff had not supported a person with care for a wound in line with their care plan and we had to intervene.
People told us that they could make suggestions or raise concerns and that they were confident they would be listened to. A person who used the service told us, "I've expressed my views and opinions to staff."
The local authority social services safeguarding team investigated an allegation that one person had not received their medication. The investigation, which was concluded shortly after our inspection, found that person had not had medication they needed on seven successive days.
None of the people we spoke with could recall seeing their care plan. They could not tell us what their care plans said about how they should be supported. However, we saw from care plans we looked at that people had been involved as much as they could have been in their care plans.
Is the service well-led?
The provider had a system for monitoring the quality of service. This included reviewing all accidents and incidents that had been reported and taking steps to reduce the risk of those happening again. Routine checks of the building and premises had been carried out.
Staff told us that they had been discouraged from questioning or challenging risky or unsafe practice. Staff had raised concerns with ourselves and the local authority that they had been bullied and harassed. The provider had acted on those concerns by suspending the registered manager.
The service had procedures for reporting of accidents and injuries. We saw that reports were reviewed and analysed and that action had been taken to reduce the risk of the same type of accident occurring again.
The provider had used a satisfaction survey to obtain people's views. The most recent survey showed that people were happy about the quality of care and support they had received and their experience of living at the home.