This unannounced inspection took place on 14 July 2015. Although this service has been in existence for many years it had been re-registered on 19 November 2014 to the current provider, Mrs Christine Mouralidarane. This is the first inspection under the new registration.
Rafael Home is a care home which provides accommodation and personal care for up to four people with learning and physical disabilities. There were four people living at the home on the day we visited.
The service had a registered manager at the time of the inspection. 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 were safe at the home; people living at the home were happy to speak with us, show us around and answer our questions. The provider took appropriate steps to protect people from abuse, neglect or harm. Staff knew and explained to us what constituted abuse and the action they would take to protect them if they had a concern about a person.
Care plans showed that staff assessed the risks to people's health, safety and welfare. Where risks were identified management plans were in place. Each person had a mobile phone and could call staff or the manager when they wanted to. Staff had taken steps to help keep people safe and support their independence.
The temperature of cooked food was monitored and the fridge and freezer temperatures monitored daily. We saw that the kitchen was visibly clean and the equipment well maintained.
We observed that there were sufficient numbers of qualified staff to care for and support people and to meet their needs. We looked at staff files and saw the correct recruitment process had been carried out to ensure staff employed were suitable for their roles.
People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Medicines were stored securely and audits of medicines conducted. These checks helped to ensure that people were safe from medicines errors.
Staff had the skills, experiences and a good understanding of how to meet people’s needs. People were cared for by staff who received appropriate training and support. Staff meetings were held monthly and one to one supervision took place every eight weeks.
The service had taken appropriate action to ensure the requirements were followed for the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are in place to protect people where they do not have capacity to make decisions and where it is deemed necessary to restrict their freedom in some way, to protect themselves or others. People had the independence and freedom to choose what they did and where they went, in safety with as little restriction on their liberty as possible.
People were supported to eat and drink sufficient amounts to meet their needs. Meals were planned according to people’s wishes and what they said they would like to eat. The food people ate was consistent with people’s dietary needs and religious beliefs.
Detailed records of the care and support people received were kept. Staff took appropriate action to ensure people received the care and support they needed from healthcare professionals.
People were supported by caring staff who had worked at the home for many years and knew the people well. Staff enabled people to make decisions by taking the time to explain things to people and to wait for the person to make a decision.
People’s independence was encouraged. The home held monthly house meetings to discuss future activities, holidays or outings
Staff asked people how they would like to be treated and how they would like their care delivered to help retain their privacy and dignity.
People’s needs were assessed and information from these assessments had been used to plan the care and support they received.
There was an easy read version of the complaints procedure and people told us they felt happy to speak up when necessary.
We could see that people knew who the manager and staff were and could freely chat with them at any time. All the people we spoke with spoke positively about staff and management.
The manager had a good understanding of their management role and responsibilities and the provider’s legal obligations with regard to CQC.
The provider had systems in place to assess and monitor the quality of the service. Weekly, monthly and annual health and safety and quality assurance audits were conducted by the home.