20 May 2014
During a routine inspection
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
This is a summary of what we found-
Is the service safe?
We saw that interactions between staff and people they were supporting were positive and enabled them to make decisions and choices. The staff understood and were able to explain the background of each person, and the support they needed. The staff demonstrated that they cared for the people they supported and it was evident that people felt safe and comfortable with the staff. We heard frequent laughter and smiles from people throughout the day.
The staff we spoke with knew and understood their responsibilities with regard to safeguarding people from abuse and harm. There had been no reports or safeguarding concerns raised since the last inspection. A safeguarding policy and local authority guidance was available and on display in the office. This meant that people could be confident that they were protected because the staff team knew how to recognise and respond to abuse.
Staff administered medications for the two people living in the care home. We saw that the MAR charts were completed accurately and that staff signed to confirm that the medications had been taken by the person. The provider's policy required two staff to sign for medication administration, and a lone worker form was completed for occasions when staff had administered on their own.
Is the service effective?
People referred to the service were assessed by a senior staff prior to being admitted to the care home. Introductory visits called 'taster sessions' were also arranged if appropriate for that person. We were told that this had been useful by a family member who said: "We were all involved in the decisions about the move and (person who used the service) visited a few times. We had enough information, and we felt it was right".
Is the service caring?
We spoke with one person who told us how they had been supported when they moved into the care home. They said they had visited before they actually moved. During these visits, the person was introduced to the staff, assessments and support plans were commenced and they decided how they would like their bedroom to be decorated and furnished. This meant that people were given choices and enabled to make decisions about their care and treatment.
Is the service responsive?
We spoke with a person who discussed and read through some of their support plan with us. We saw that the support plan was detailed and included involvement of other health professionals. This person also showed us their emergency plan which was displayed on their bedroom wall. This meant that people could be confident that their needs would be met in the event of an emergency situation.
We saw that people were supported to attend medical appointments outside of the home. One person attended a dental appointment on the day of our inspection. We read the care documentation which confirmed that there was support from other heath professionals and recommendations were implemented. This meant that people could be confident that they received continuity of care as their needs changed.
Is the service well led?
Staff told us that they had supervisions with the manager every three months and they had annual appraisals. Actions were agreed and progress was monitored. We saw that the records were in place, up to date and that planned meeting dates were agreed.
We looked at the on line training records and saw that mandatory training was up to date. Staff told us: "We also do other training if we ask for it", and: "Dimensions (the provider) try to make sure that people have the best quality, they really do want the best for people".
We found that three monthly quality assurance audits were undertaken by the provider's compliance team. A service improvement plan was generated and actions monitored. The most recent audit was completed in March 2014. This confirmed that most of the previous actions had been achieved and the manager informed us that they would be considered for a 'light touch' audit in June 2014.
The provider may wish to consider why their quality assurance system had not identified and addressed the unsecure storage of care records which we were told were for archiving in the room designated as the staff room, and the hole in the door where the lock had been drilled out. We were told that actions would be taken to address these concerns as a matter of urgency.