The inspection was carried out by an adult social care inspector. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well led?As part of the inspection we spoke with seven people who lived at the home, nine relatives, seven care staff, two domestic staff, the chef, deputy manager and the registered manager, who was also the provider. We reviewed policies and records relating to the management of the home which included, six care plans, daily care records and seven staff files.
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.
Is the service safe?
We found that people were cared for in a fresh and clean environment and that the home was well maintained.
We found that the service was individually tailored to meet people's care needs and that people were treated with dignity and respect by the staff.
There were systems, policies and procedures in place which ensured risks to people were reduced and that the service was safe. Risk assessments had been undertaken which were regularly reviewed. This helped to ensure people received care that was safe. People were given choice and remained in control of decisions about their care and lives.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No applications have needed to be submitted in the last year. We noted that the home had appropriate policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards in place.
The home had systems in place which ensured staff learnt from adverse events such as accidents and incidents. These were investigated and followed up which helped risk to be managed and kept people safe.
We examined six staff files and found that the recruitment, selection and training processes were thorough, which meant that suitably skilled and qualified staff were employed to provide a safe service.
One of the people we spoke with said, 'I'm safe here, I can talk to anyone'. A member of staff said 'we're here to protect people ' that's what we do'.
Is the service effective?
People we spoke with and their relatives were very positive in their comments about the home and the service provided. A relative told us they were 'very lucky to a get room in the home. The home has a good reputation locally'. Another relative commented, 'the professional care and superb meals mixed with a friendly relaxed atmosphere is very impressive and much appreciated'.
Where people lacked capacity to consent to their care the provider had arranged best interest meetings which ensured the care and support provided was agreed.
People's health and care needs were assessed with their involvement and a family member or representative. Care plans were continually reviewed and updated wherever a change occurred. From speaking with staff it was clear they knew people well and understood people's individual care and support needs.
We observed how staff cooperated and supported with each other to make sure no one was kept waiting and everyone received the care and support they needed at the right time.
Is the service caring?
We found that the home was homely cosy and comfortable. No one was rushed or hurried and we noticed gentle, calm reassurance from staff coupled with a touch of humour.
Care, treatment and support were person centred, and planned to take account of individual preferences, wishes and choice.
We observed friendly, warm exchanges between people, visitors and staff. Staff were kind and attentive. We saw that the staff encouraged and supported people in making their own decisions about how they needed help and spent their time.
We met and spoke with nine relatives who visited the home on the day of the inspection. They told us they were always welcomed at any time and said there was always someone on hand to talk to. One relative we talked with said, 'my Mum has settled in very well. She likes the company'. Another relative commented on the amount of time that had been taken with their relative when they first arrived to make sure they were comfortable.
Is the service responsive?
We found that staff responded promptly to people's requests for help. We observed that where a person needed extra support staff worked well together and supported each other to ensure matters were dealt with quickly without fuss or embarrassment.
People's health and care needs had been assessed prior to their arrival at the home. We reviewed six care plans and found that records were well organised, up to date and accurate. The care plans confirmed people's preferences, interests and diverse needs which ensured care and support provided met individual need. Care plans were held in people's rooms which meant they could easily be accessed.
Care plans were updated daily and regularly reviewed which meant that staff were able to respond promptly to people's changing needs.
The people we spoke with said that staff were 'always around' and told us if they needed anything they would use their call bell. We noticed that staff had time to talk with people in the lounge, in the garden and with those who chose to stay in their rooms. We noted that the internet had been installed in the home at the request of one of the people and this illustrated how the provider responded to individual requests for improvements to the home's facilities.
Is the service well led?
There were systems in place to monitor the quality of the service provided. People, their relatives, outside professionals and the staff were encouraged to provide feedback on the service. Suggestions and ideas for improvement to the service were welcomed and acted on.
Meetings between people, their relatives and staff were used as opportunities for issues to be raised, discussed and shared before any changes to the management of the home were implemented. One of the visitors we spoke with said, 'the home is very open ' you can say anything to any of staff if there are ever any concerns'.
The registered manger had introduced new working practices for staff which had clarified roles and improved procedures to the benefit of people in their care.
Changes had been implemented to the staffing structure which had provided staff with greater opportunities to develop their skills and experience. The home benefitted from a stable and experienced staff team.
The home worked closely with other agencies and local services and had developed close working relationships and collaborative working practice which helped to provide an effective service for people at the home.
Clear management structures and lines of accountability were in place. Staff understood their roles and responsibilities and had a good understanding of the ethos and values of the home and to quality processes in place.
The home benefitted from the experience of the provider, who was also the registered manager, who worked together with people and staff to ensure a quality service was provided.