We visited Agnes House Flat 2 and carried out an inspection there. On the day of our inspection, the registered manager told us that one person lived there. We spoke with the registered manager, care staff on duty and the relatives of the person that lived there. We looked at their recorded information to gain a balanced overview of the quality of the care and support that they experienced. We considered all of the evidence that we had gathered under the outcomes that we inspected. We used all the information to answer the five questions that we always ask;' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
Below is a summary of what we found. The detailed evidence supporting our summary can be read in our full report.
Is the service safe?
Relatives spoken with told us that their family member was treated with dignity and respect by the care staff. They were on home leave on the day of our inspection. Relatives told us that their family member was given choice about their care and how they spent their day. We spoke to them about their experiences and they said, 'My relative loves being there. The staff make sure they are safe in the home or when they are out. Staff are really kind.' The local authority representative for the person that lived here, that we spoke with told us that they were very happy with the care and support the person received. They told us, 'They (the individual) are safe and well cared for by very committed staff. Their safety, health and wellbeing is promoted and protected. They are settled and happy when they are there.'
Records sampled showed that the provider had systems in place to establish whether people had capacity to give their consent to receive care and were able to make informed decisions. The registered manager told us and records showed that all staff had received DoLS and Mental Capacity Act 2005 training. This ensured that staff understood their responsibilities and the provider had taken the appropriate action to ensure that the rights of people were protected.
The registered manager told us and we saw records which showed that applications had been made to the local authority for them to consider. The local authority determined that people who lived here were not deprived of their liberties.
The provider had policies and procedures in place to protect people from harm. All staff spoken showed that they understood what safeguarding people meant. Staff all had up to date training on how to protect vulnerable adults and how to support a person when they displayed behaviours that may harm themselves or others. This meant that the safety of people who lived there and of others was promoted and protected.
We saw that the person that lived there had an assessment of their needs and associated risks. A plan of care was completed which enabled staff to offer care and support to them in a safe way. Staff told us and records sampled showed that they had received training and support to enable them to deliver care safely.
We saw that systems were in place to make sure that learning takes place from accidents, incidents, complaints and investigations. This reduced the risks to people and helped the service to continually improve.
Is the service effective?
The representative that we spoke with confirmed that they could visit throughout the day. We saw that facilities were available so that people could meet in private if they wanted to.
Records sampled showed that the persons relative had had been involved in an assessment of their needs and staff had used a variety of means to establish what support people needed and their choices explored for example using pictorial or other languages. This meant that the individual had been able to influence the care they received where possible and their individuality and cultural needs had been respected.
We saw that representatives and where appropriate, relatives were involved with people's care. One representative told us, 'They always ensure that my client's holistic health and emotional care needs are well met, they involve other health professionals and inform me what is happening.'
All staff spoken with were able to give us good detail about the support they provided. People's health and care needs were assessed and care plans told staff what people's care needs were so they could support people consistently. Referrals had been made to external professionals so that the person they supported got the support they needed to maintain their health and wellbeing and we saw that staff followed their advice.
Records sampled showed that the person who lived here was encouraged to eat a healthy and nutritious diet. We saw that they had a choice of what to eat and records indicated they enjoyed the food provided. We spoke to their relative about their meals and they said, 'The staff have a list of their likes and dislikes but they let my relative make choices of what to eat and when. They don't like spicy food and they respect that choice. ' We saw that their weight was recorded regularly. This is important as a significant loss or gain of weight could be an indicator of an underlying health need. This meant that they were supported to eat and drink sufficient amounts to meet their needs and ensure their wellbeing.
Is the service caring?
We saw records to show that the persons preferences, interests and aspirations and diverse needs of the person that lived here had been recorded in their care records and that their cultural needs were respected and met. Relatives spoken with told us that staff treated people with dignity and respect, were patient and caring they took their time and did not rush them.
People, their relatives and other professionals involved with the service had completed an annual satisfaction survey. We saw that relatives had made positive comments in the surveys we looked at.
Is the service responsive?
We saw that the person who lived here was supported and encouraged to take part in a range of activities at home and in the local community. We saw that staff responded to spontaneous requests from them to do activities, or to spend their time in a way that they preferred. We saw that when needed staff had requested the involvement of other health professionals in their care and followed their guidance.
Is the service well lead?
The home had a manager who was registered with us, CQC. They were experienced and knowledgeable about the needs of the people that lived in the home.
We found that robust systems were in place to regularly assess the quality of the service that people received. Records showed that regular spot checks on staff skills and work practices were by carried out by the manager. We sampled the findings and saw that they were detailed and feedback was provided to staff following these checks. Supervision and training records showed that supervision and staff training was regular and up to date. This ensured that people received care from staff that were suitably skilled to deliver care and feedback was continuously given on their performance.
All staff that we spoke with were clear about their role and responsibilities. They had a good understanding of the ethos of the home and the systems in place to monitor quality assurance. This ensured that people received good quality of care.