One adult social care inspector inspected Caring in Care Limited at Holly Cottage. At the time of the inspection there were nine people using the service. The registered manager was on annual leave and we could not therefore speak with them. We spoke with the deputy manager, three care staff and four of the people who used the service. We reviewed the care records for three people. We also reviewed a selection of other records including staff rotas, audits and the provider's policies and procedures.
We used the evidence we collected during our inspection to answer five questions.
Is the service safe?
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA), 2005, and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The MCA provides a framework to empower and protect people who may make key decisions about their care and support. The DoLS are used if extra restrictions or restraints are needed which may deprive a person of their liberty.
We saw evidence that the registered manager had acted in accordance with the law in relation to the MCA and DoLS. People who used the service had received appropriate mental capacity assessments and 'best interest' decisions were recorded appropriately. No person living in Holly Cottage had a DoLS authorisation at the time of our inspection.
There were effective systems in place to manage and monitor the prevention and control of infection. These included policies and procedures, an adequate cleaning schedule and the provision of Personal Protective Equipment (PPE). During our inspection we noted that infection control procedures were correctly followed. There was one exception to this in relation to a care worker not following the correct procedure for the laundering of contaminated linen. We have highlighted this to the provider.
People who used the service told us that they felt there were enough staff on duty to meet people's needs at all times. We reviewed three weeks of staff rotas and saw evidence that the provider's required number of staff on duty had been met.
There were effective systems in place to record and investigate accidents and incidents. These were audited by the registered manager and plans were put in place to reduce the risk of repeat occurrences.
The provider had effective arrangements in place to manage foreseeable emergencies. These included plans in relation to fire and evacuation, and medical emergencies.
Is the service effective?
All of the people we spoke with told us that they felt that their needs had been met. People's care records demonstrated that their needs had been assessed and there were detailed care plans and risk assessments in place. Care and support was evidence based and included nationally recognised screening tools.
Plans of care and risk assessments had been regularly updated in order to reflect any changes in people's needs.
The provider worked closely with other health and social care professionals. These included dieticians and speech and language therapists. This meant that people received care and treatment from a multidisciplinary team that helped to address all of their needs.
Is the service caring?
All of the people we spoke with told us that they were happy with the care that they received. One person said, 'The staff here are great and look after me well. I don't have any concerns. I get well attended to.' Another person said, 'I am happy here, it's good. There are lots of things to do. I keep myself busy.'
During our inspection we observed staff to be kind and caring to people at all times. Staff took their time to ensure that people understood what was being said and to encourage people's independence in relation to their activities of daily living. Where people required assistance, staff ensured people's privacy and dignity was maintained.
There was a positive interaction between staff and people who used the service. It was evident that the staff knew the needs of people well.
Is the service responsive?
People's care plans responded to their physical and mental health needs as well as their social needs. The care and support delivered to people reflected their goals and aspirations. An example of this was staff helping a person to live a more independent life that had resulted in them being able to move to a new service suitable for more independent living.
The activities that people undertook responded to their individual choices and preferences. These included both educational and social activities. All of the people we spoke with told us that the activities were meaningful to them.
The provider had a complaints policy and procedure and we saw evidence that they took account of complaints and comments to improve the service.
Is the service well-led?
Holly Cottage was well led. The registered manager had effective quality assurance arrangements in place. These included receiving feedback from people who used the service, their relatives, health and social care professionals and the staff. We saw evidence that the results from 'satisfaction' surveys had been acted upon by the manager. This meant that they took account of people's views in order to improve the quality of the service.
All of the staff we spoke with told us that they felt well supported. They told us that the manager shared information with them and that they felt confident to raise any concerns or issues.
The staff we spoke with understood their roles and responsibilities and knew when they needed to 'escalate' an issue or problem to the manager or the senior care staff.
The culture within the service was seen as positive. Staff told us that they were asked by the manager whether they had any ideas to improve the service on a regular basis. They told us that they were always listened to and that the manager acted on what they said. This meant that the staff were supported to try new ways of working to improve the quality of the service where appropriate.