This inspection visit was undertaken by two inspectors and an expert by experience. At the time of our inspection there were 42 people living at the service. We spoke with fourteen people using the service, six relatives, nine members of staff and the manager. We looked at seven people's care plans as well as quality assurance records kept by the provider. We considered all the evidence gathered under the outcomes inspected. We used the information to answer the five questions we always ask: - Is the service safe, effective, caring, responsive and well led?
This is a summary of what we found-
Is the service safe?
The home environment was safe, clean and well maintained. Individual assessments identified risks presented by people and management plans were in place to enable staff minimise the risks presented.
People told us that the care staff treated them well and they felt safe. Comments included 'It's nice here', 'Lovely here' and 'Very nice.' Staffing levels were appropriate to keep people safe and meet their needs.
New staff had a complete induction, completed training on how to safeguard vulnerable adults, and shadowed experienced staff before they worked unsupervised. The service had a training and development programme in place, and staff had access to mandatory training such as moving and handling, safeguarding and fire safety. Records were kept by the service to ensure that this important mandatory training was kept up to date.
Is the service effective?
People's identified needs were being met by suitably skilled staff who had the necessary qualities for their roles. Staff received the support and supervision that helped them do their jobs.
Staff liaised with health professionals and followed their advice in looking after people in a way that promoted their health and welfare. Staff were observant and summoned help promptly from health professionals if people had a change in their conditions or became unwell.
People enjoyed the meals they were served as they took into account their preferences and dietary needs.
Care plans were up to date reflecting individual care needs across important areas such as mobility, personal hygiene, communication and sleep.
Further work could take place to make the environment more homely, personalised and 'dementia friendly' for the people living on each of the five clusters. It was sometimes difficult to differentiate one area from another with corridors and lounges quite uniform in appearance and lacking 'identity'.
Is the service caring?
People using the service told us that staff treated them with respect and they were happy living at the home. Feedback included 'The staff are alright to me', 'The nurses are nice to me' and 'Some of them are nice.' One person told us 'They come quick' when talking about using the call bell and said that staff had supported them that morning with a shower.
Staff understood the importance of treating people with dignity and respect and said they were made aware of the standards expected of them in this important area. The service demonstrated it monitored staff practice and took appropriate action as necessary to address any shortfalls.
Staff were familiar with people they looked after and knew what was expected to enhance their quality of life.
Is the service responsive?
Care was planned and delivered in line with people's individual care needs. People's care plans had essential information recorded for staff to see about their needs around ability, age, disability, gender, race, religion and belief and sexuality. Relatives were involved when appropriate in discussions about how people liked to be supported. Regular reviews of individual needs made sure any changes were identified and addressed.
We had mixed feedback from people using the service about the activities provided within the service or in the community. Some people said they would welcome more things to do as they were sometimes bored. Comments included 'Not much to do ' and 'I would like to go out to pubs more." However a person told us "My elderly parent likes to spend time in their own bedroom, having the radio on and reading the paper, they invite others in on occasions for a chat, staff respect their decision".
Is the service well-led?
The service had a registered manager in post for the past eighteen months. This has provided stability to the staff team. Staff told us they got support and training needed which helped them to meet people's needs.
The quality of the service was assessed by the service provider so they could identify any improvements that were necessary. The systems in place for regularly assessing and monitoring quality and risk matters at the service included monitoring the environment, care plan records, medication procedures, and maintenance of the building, and handling of complaints.
Quality assurance processes however could be developed to be more outcome led and focussed on peoples experiences living in the home using observation tools and peer review audits.