Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with six people who used the service and two relatives and asked them for their views. We also spoke with two care workers, a team leader, a nurse, the recently appointed home manager and the area manager. The named registered manager had recently left the service, but the provider had not informed us of this. The provider had recruited a new manager who started work three weeks prior to our visit and they told us they would be applying to become the registered manager within the next month.We looked at some of the records held in the service including the care files for five people. We observed the support people who used the service received from staff and carried out a brief tour of the building.
We carried out this inspection to answer 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 we observed, the records we looked at and what people using the service, their relatives and the staff told us.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
We found people's care and support was not planned and delivered in a way that ensured their safety and welfare. Systems in place to ensure people received their medication safely were not always followed and medicines were not always safely administered.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager informed us after the inspection they had made one application and was waiting for the result of this and the required policies and procedures were in place for this. The manager said relevant staff will be trained to understand when an application should be made, and how to submit one.
Is the service effective?
We found the provider had effective systems to involve people in planning their care, and obtaining people's consent for this to be provided. A person who used the service told us, 'We talk about my care, they keep me happy.'
We found staff were not always effective at meeting the care and welfare needs of all the people who used the service. A relative told us they had some concerns about the night time care of their relation. The documentation completed did not make this clear so staff could not effectively answer the relative's concerns.
The number of staff employed and how they were deployed had been identified as reasons why staffing arrangements in the home were not effective and action was being taken to resolve this.
Is the service caring?
We found the care and welfare needs of people who used the service were met in a sensitive and caring manner. People who used the service told us staff made them feel safe and well cared for. A person who used the service told us, 'The care here is very good, they don't forget you. The food is very nice too.'
Is the service responsive?
We found care workers responded appropriately when people had the capacity to make decisions about their care and welfare. We saw people who used the service were asked for their views by staff over every day matters.
We found staff responded appropriately to the care and welfare needs of people who used the service. A person told us, 'Staff make sure I am alright, I feel safe here. They come and move me to stop me getting sore.'
Is the service well-led?
We found the provider did not protect the rights of people who did not have the capacity to consent as staff did not know how to complete an assessment to determine if a person had the capacity to make a decision.
The manager told us they were putting management systems, including quality assurance systems into place and these would be used to make improvements to the service. A person who used the service told us the new manager, 'Knows what she is doing, she gets things done.' A relative said, 'I have faith in her, she know what to do.'