We inspected Framland on 23 May 2017. The visit was unannounced. This meant that the staff and the provider did not know that we would be visiting.Framland is located in Melton Mowbray, Leicestershire. The service provides accommodation for up to 31people who require personal care. There were 27 people using the service at the time of our inspection.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they felt safe living at Framland. The staff team knew their responsibilities for keeping people safe from harm. This included reporting any concerns to a member of the management team.
Assessments had been carried out on the risks associated with people’s care and support. This enabled the registered manager and management team to identify and reduce the risks presented to both the people using the service and the staff team.
People’s thoughts on staffing levels at the service varied. Whilst some people felt there were enough staff members to meet their needs, others did not. This resulted in people having to wait for support from the staff team or it having an impact on the care they preferred.
Appropriate checks had been carried out when new members of staff had started working at the service. This was to make sure that they were suitable and safe to work there. An induction into the service had been provided and on-going training was being delivered.
There were systems in place to audit the medicines held at the service and appropriate records were being kept.
Not all areas within the home were clean, appropriately maintained or hygienic.
People received support from a staff team that had the necessary skills and knowledge. New members of staff had received an induction into the service when they were first employed and training relevant to their role had been provided.
People had been involved in making day to day decisions about their care and support. Where people were unable to make their own decisions, these had been made for them in consultation with people who knew them well and in their best interest. The staff team were working in line with the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards.
People’s nutritional and dietary requirements had been assessed and a balanced diet was being provided. For people who had been assessed to be at risk of not getting the food and drink they needed to keep them well, appropriate records were kept so that this could be monitored.
People were supported to maintain good health. They had access to relevant healthcare services such as doctors, community nurses and opticians and they received on-going healthcare support.
People told us that the staff team were kind and caring. The relatives we spoke with agreed with this. On the whole we observed the staff team treating people in a kind manner though there were some occasions where this could have been improved.
Whilst activities for people using the service were being provided, these were being carried out by the care staff team alongside their other duties. Records did not always show that people were regularly supported to follow their hobbies or interests.
People had plans of care that reflected their care and support needs. These provided the staff team with the information they needed in order to properly support people using the service though these had not always been followed. Staff knew the people they were supporting including their likes and preferences.
A complaints procedure was in place and people we spoke with were aware of who to talk to if they had a concern of any kind.
The staff team felt supported by the registered manager. They were provided with the opportunity to meet with them on a regular basis and felt able to speak with them if they had any concerns or suggestions of any kind.
Staff meetings and twice monthly surgeries for the people using the service and their relatives and friends were being held. These provided people and staff with the opportunity to be involved in how the service was run. Surveys were also being used to gather people's views on the service provided and the feedback was used to make improvements.
A business continuity plan was in place for emergencies or untoward events and personal emergency evacuation plans were in place should people using the service need to be evacuated from the building.
Whilst there were systems in place to regularly monitor the quality and safety of the service being provided these had not identified the shortfalls identified during our visit or rectified the shortfalls identified at our last visit in March 2016. This included infection control issues identified within the environment and with regards to the monitoring of records.
The registered manager understood their legal responsibility for notifying CQC of deaths, incidents and injuries that occurred or affected people using the service.
We found the service was in breach of one of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.