13, 16, 30 August 2013
During a routine inspection
We looked at the care records of 10 people spoke with five members of staff and 16 people's relatives. People we spoke with gave a variety of views regarding their experience. Some people told us the service was good and there child was receiving good levels of care but did tell us that there were problems with staff not always turning up on time or not at all.
Other people did not speak positively about the service and told us they felt that staff had a poor understanding of their child's needs and were not able to effectively engage and communicate with people. They told us that although staff were kind and pleasant that they had in some instances had to refer their concerns to social workers.
We looked at how people were involved in the planning of their care, and although people were asked about when they wanted to receive care this was not always carried out in accordance with people's wishes. We also found that people's care records did not contain enough information about professionals involved in people's care and how they were supported.
We found care planning and risk assessment required improvement. There was not sufficient information in people's plans to inform staff how to care for people appropriately. For example care plans did not contain strategies and intervention relating to behaviours that challenge or where people had limited communication. We looked at staff training and found that staff had not received adequate training to meet people's needs. For example staff had not received training in Autism, Challenging behaviour, sign language or epilepsy. All of which are conditions that people required support and care.
We looked at the system in place to ensure people were protected from abuse and found this to be adequate. Staff knew how to report incidents of abuse and also how to identify it. The service was able to give examples of incidents that it had referred to leading authorities where abuse had been identified. We also found staff had received training in identifying and reporting abuse.
We looked at the system in place for monitoring the quality of the service. Although the system did highlight issues regarding training it did not identify concerns relating to poor engagement of people, improvements required in relation to care planning and risk assessment and improvements required in relation to incident reporting and analysis.