We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;' 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 '
Is the service caring?
We saw that people's needs were assessed and care delivered in line with their assessed needs. We saw that people had access to outside professionals such as doctors, dentists and opticians. This meant there were systems in place to help maintain their health and wellbeing. One person who used the service told us, "This place is very comfortable. We are well cared for, well fed, loved; I am very happy here.' Another person we spoke with said," I like living here. I have been here four years and I am very happy.'
We observed that staff responded in a caring and compassionate way to people's needs and had a good understanding of people's individual likes and dislikes. We saw care staff interacted well with people, were warm, supportive and spent individual time with them. We observed staff supported people to be as independent as possible. One person we spoke with told us, 'The staff are OK; they should get a gold medal.'
Is the service responsive?
People's needs were assessed and their care plans reviewed and revised in line with their changing needs. People had access to a range of outside services to ensure their health and wellbeing was maintained, including doctors, dentists and opticians.
We saw that people's dietary needs were catered for. People were offered choices about meals and any special dietary requirements, such as for diabetes were provided. People we spoke with told us that the food was good and that they got a choice of meals. One person told us, 'The food is A-OK; it's really good food.' Another person told us, 'The food is OK, you get what you want.'
We found that staff had a good understanding of people's individual needs, likes and dislikes. We saw that people's choices were noted. For example, people had indicated what food they did or did not like. Another person had been helped to register as an organ donor. We saw that one person did not have English as their first language. We saw from records that interpreters had been used to try and improve communications with the person.
Is the service safe?
People were cared for in an environment that was safe and well maintained. Audits of safety systems were in place. People had individual personal emergency evacuation plans which detailed the help they would need if there was a fire or similar event.
The building was clean and tidy and people had access to soap and towels. The kitchen and bathroom areas were regularly cleaned. Fridge and freezer temperatures were monitored to ensure food was kept in good condition.
However, we found that checks on the safety of equipment within the home were not formally undertaken meaning there was no system to ensure that electrical items in use had been assessed as being safe to use. We have asked the provider to tell us what they are going to do to ensure that proper checks are undertaken and recorded.
We spoke to the staff member on duty at the time of our inspection. She told us that having one staff member and the support of the deputy manager and manager during the day was sufficient. The manager told us, and records confirmed that a lone working policy was in place for the service.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager told us that no applications have needed to be submitted and people's care plans reflected that the issue of capacity had been assessed and considered. All people using the service were assessed as having the capacity to make decisions about their life. Staff within the home had received training on DoLS and the Mental Capacity Act 2005.
Is the service effective?
People told us they were happy with the care that had been delivered and their needs had been met. People who used the service told us there were enough staff and they were supportive. One person told us, 'All the staff are really good.' Another person said, 'I think the staff are alright.'
People's nutritional needs were assessed and food and drink was supplied, taking into account individual needs and preferences. People's weight was regularly monitored and where there was concern about weight additional advice was sought.
We noted there was a system in place for a rolling programme of regular audits and reviews of people's care records and to update risk assessments.
We saw that any training undertaken was logged and a date highlighted when this training needed to be updated. This meant that there were systems in place, to ensure that staff had up to date knowledge and information in order to carry out their roles.
Is the service well led?
The home had a range of quality assurance systems in place to monitor the quality and consistency of care. We saw copies of documents regarding checks on medication, care records and nutrition.
We saw that accidents, complaints and safeguarding incidents were investigated and, where necessary, action taken to change or improve care delivery.
People who used the service confirmed that there were regular residents' meetings and we saw copies of notes from these meetings.
Staff confirmed that there were regular staff meetings and we saw minutes from this meeting. Staff told us, and records confirmed that they had regular supervision with a senior member of staff and yearly appraisals.