Background to this inspection
Updated
3 December 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 14 September 2015 and was unannounced. This meant the staff and the provider did not know we would be visiting. The inspection was carried out by an adult social care inspector, a specialist adviser in nursing and an expert by experience. The expert by experience had personal experience of caring for someone who used this type of care service.
Before we visited the home we checked the information we held about this location and the service provider, for example we looked at the inspection history, safeguarding notifications and complaints. We also contacted professionals involved in caring for people who used the service, including commissioners, safeguarding and infection control staff. No concerns were raised by any of these professionals.
During our inspection we spoke with four people who used the service and five relatives. We also spoke with the registered manager, administrator, handyman and four staff.
We looked at the personal care or treatment records of three people who used the service and observed how people were being cared for. We also looked at the personnel files for three members of staff.
We reviewed staff training and recruitment records. We also looked at records relating to the management of the service such as audits and policies.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We spoke with the registered manager about what was good about their service and any improvements they intended to make.
Updated
3 December 2015
This inspection took place on 14 September 2015 and was unannounced. This meant the staff and the provider did not know we would be visiting. Four Ways Care Home was last inspected by CQC on 27 September 2013 and was compliant.
Four Ways is located in the town of Stanley, County Durham. The service comprises of three adjoining terraced houses each with their own distinctive design and layout. It provides residential care and can accommodate up to 13 people who have a learning disability. On the day of our inspection there were 12 people using the service.
The home had a registered manager in place. A registered manager is a person who has registered with 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. The service was in the process of changing registered provider.
People who used the service were complimentary about the standard of care at Four Ways Care Home and were asked about the quality of the service provided. We saw staff supporting and helping to maintain people’s independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.
We saw the home was clean and tidy with no unpleasant odours.
There were sufficient numbers of staff on duty in order to meet the needs of people using the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Training records were up to date and staff received supervisions and appraisals, which meant that staff were properly supported to provide care to people who used the service.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) is part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We discussed DoLS with the registered manager and looked at records. At the time of our inspection visit, DoLS were in place for people who required them however DoLS notifications had not been submitted to CQC. We discussed this with the registered manager and this was addressed on 17 September 2015.
We found evidence of mental capacity assessments or best interest decision making in the care records. Staff were following the Mental Capacity Act 2005 for people who lacked capacity to make particular decisions and the registered manager had made applications under the Mental Capacity Act Deprivation of Liberty Safeguards for people being restricted of their liberty.
People were protected against the risks associated with the unsafe use and management of medicines.
People had access to food and drink throughout the day and we saw staff supporting people at meal times when required.
People who used the service had access to a range of activities in the home and within the local community.
All the care records we looked at showed people’s needs were assessed before they moved into the home. Care plans and risk assessments were in place when required and daily records were up to date. Care plans were reviewed regularly.
We saw staff used assessment tools and kept clear records about how care was to be delivered and people who used the service had access to healthcare services and received ongoing healthcare support.
The layout of the buildings provided adequate space for people with walking aids or wheelchairs to mobilise safely around the home.