16 March 2018
During a routine inspection
There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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. The current registered manager was due to leave their post soon and a new manager is currently in the process of becoming registered with the CQC. We shall monitor this application.
At the time of the inspection 82 people received some element of support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection, the service was rated as ‘Good’ overall. At this inspection, they maintained that rating. However, the rating for the question, ‘Is the service safe?’ has changed from Good to Requires Improvement. This was because we had concerns with the way people’s medicines were managed.
People told us they were happy with how their medicines were managed. However, we found issues with the way staff recorded when people had or had not taken their medicines and the processes for the administration of ‘as needed’ medicines. People told us they felt safe when staff supported them. The risks to people’s safety were assessed and acted on. More detailed plans for the safe evacuation of people from their homes in an emergency were needed. Staff arrived on time for calls. Robust recruitment processes were in place. Staff understood how to reduce the risk of the spread of infection. Accidents and incidents were investigated and plans were put in place to reduce the risk of them happening again.
People’s care was provided in line with current legislation and best practice guidelines. Staff were well trained and understood how to support people effectively. Staff performance was regularly monitored. The risks to people’s health because of poor nutrition were assessed and acted on.
Information was available to support the involvement of other health and social care agencies where further support was needed for people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People liked the staff who supported them and they found them to be kind and caring. People were treated with dignity and respect. People felt involved with making decisions about their care. People were encouraged to do as much for themselves as possible. People’s diverse needs were respected. People were provided with the information needed to access an independent advocate.
People’s needs were assessed prior to them starting with the service. This enabled the provider to be satisfied that they could meet people’s needs. People felt involved with their care and people were treated equally without discrimination. This included ensuring people with communication needs were offered equal opportunities to access records relating to their care. The majority of people felt care staff responded to their complaints well, although some felt office staff could do more to improve the service they received.
The service was led by a caring registered manager who was well liked by people and staff. Staff enjoyed their jobs, they felt appreciated and excellent performance was rewarded. Relatives had been given the opportunity to comment on the quality of the service provided. People who used the service were soon to have their opportunity to give their formal feedback. The provider ensured the registered manager had the support needed to manage the service effectively. Auditing processes were in place and these had identified some of the issues we identified and were being acted on. The registered manager carried out their role in line with their registration with the CQC.