A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People felt safe because their rights and dignity were respected when making decisions about any risks that they may wish to take. People were safe because the provider had a system to manage accidents and falls and learnt from them, so they were less likely to happen again. For example, the provider kept records that analysed and monitored falls. They also detailed what actions were taken to assist people to maintain their safety after a fall.
Staff understood about the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and how they would be put this into practice. No DoLs applications had been submitted but the provider was undertaking a review of this.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people living in the home were protected from avoidable harm, abuse and breaches of their human rights.
The people considered they were kept safe and were listened to. We observed that people were free to go about their daily routine as they wished. One person told us, 'I feel happy here. The staff are always on hand to help me and I can do as I please.' A relative said, 'Since my mother has deteriorated the staff have helped me enormously. They communicate well with me and I know my mother is safe.'
Is the service effective?
People we spoke with said they felt confident discussing their health needs with staff. They said their health was regularly monitored to identify any changes that may require additional support or intervention such as referral to the GP or dietician. We looked at records that showed referrals were quickly made to health services when people's needs changed. Records noted that relatives were kept informed. A relative commented, 'I was informed of all visits made by GPs and the recommendations made by them.' Another said, ' X improved, thanks to the swift action taken by the staff at the time, calling the doctor and keeping me fully informed and updated at all times. I was confident X was receiving appropriate, dignified and gentle care day and night.'
Staff we spoke with demonstrated they had the skill and knowledge to meet people's assessed needs, preferences and choices at all times. Staff had discussed and recorded important issues around consent to care and when people did not want to be treated. They had also explored whether people's family were to be included in decisions and this was respected. People told us they were happy to discuss their personal preferences with staff. They said that staff kept an eye on them and got help very quickly if they were unwell. This meant people were supported to maintain good health, have access to health care services and received on-going support.
Is the service caring?
The people we spoke with told us they felt that their dignity was respected and they were assisted to live their life as they wished. Staff took the time to find out people's personal social histories. Staff we spoke with knew people's needs well and how they wished to be cared for. This meant that staff cared about the person as an individual and were concerned about their well-being.
People and those that mattered to them were encouraged to make their views known about their care. A relative we spoke with confirmed that staff considered their views were important and were respected. This meant that people were listened to and they felt that their views mattered.
Is the service responsive?
The registered manager and the team of staff demonstrated a clear understanding of the importance of communicating with people and their relatives to find out their aspirations, preferences and diverse needs. Care records detailed how people's individual needs were regularly assessed and met. Detailed nutritional records were kept with clear instruction for staff.
Staff told us that a situation would be considered under the Mental Capacity Act 2005 if people did not have capacity, so that decisions would be made in their best interests. The way staff interacted with people showed that they actively sought and listened to people's views and decisions. This meant people were supported to express their views and be actively involved in making decisions about their care and support.
Is the service well led?
The management and staff demonstrated values that included involvement, compassion, dignity, respect and independence. Staff we spoke with showed they understood this as they discussed their role and responsibilities in their work. This meant the service promoted an open culture that was centred on the individual and empowered them to take control of their life as they were able.
Developments in guidance and best healthcare best practice were used as an opportunity for learning and improvement. For example, the service was exploring how they could provide dementia care for people. This would mean people would be assured of appropriate management and decision making on their behalf if they developed a dementia related illness.
Concerns were listened to. The provider hadn't received any complaints but people told us they would 'Go straight to the manager' if they were unhappy.
The provider had systems in place to assess and monitor that staff had the right competencies, knowledge, qualifications, skills and experience to meet the needs of people. This meant staff were motivated to carry out their role and to meet people's needs.