The inspection was completed by a single adult social care inspector. At the time of this inspection the current registered manager was in the process of deregistering and a new manager was in the process of registering.On the day of the inspection the service was being provided to 56 people. As part of the inspection we were following up on previous non-compliance relating to a quality audits not being completed and actions not been taken on findings of customer survey's. As part of this inspection we spoke with seven people who used the service and two relatives. We spoke with the new manager and area manager. We looked at four care records and spoke with five care staff. We sampled staff records and reviewed records relating to the management of the service.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at. We used the evidence we collected during our inspection to answer five questions.
Is the service safe?
Risk assessments were in place for things such as moving and handling and more general issues such as the environment. Control measures had been put in place in risk management plans. This meant that people's needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. One person said, 'Yes I feel safe, I have no trouble they are very good.' A relative said, 'The staff that go in are tremendous.'
Documented procedures were in place for the Mental Capacity Act 2005. We were not able to see any mental capacity assessments or best interest decisions on day the day of inspection. This was because the new manager told us that people had capacity. We saw that where people had power of attorneys this was recorded. Staff had an awareness of the Mental Capacity Act 2005 (MCA). Staff and records showed staff had received training in this. This meant that systems were in place to safeguard people as required.
People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff had been trained in safeguarding vulnerable adults and knew what to do in the event of suspected abuse.
Staff had received appropriate professional development and were able to obtain further relevant qualifications. Staff wore uniforms and carried identification badges so people could ensure people supporting them were employed by the provider. This meant people's safety was maintained. One relative said, 'Staff are nicely turned out and are caring.'
Is the service effective?
People experienced care and support that met their needs. People told us how they were supported. We saw that doctors had been contacted when people were unwell. People's care was reviewed regularly. People's views were gained when managers did quality checks on staff. This was confirmed by people and their relatives. This meant that people received care in the way they wanted.
We saw systems were in place to gain consent from people. People or their relatives had signed consent forms and risk assessments to demonstrate their agreement. Staff told us they sought people's consent daily through asking them what they would like and how they would like things. This meant people received care in the way they wanted.
Regular audits were now taking place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.
Is the service caring?
People were supported by friendly and considerate staff. Staff we spoke with told us how they supported people. People and relatives confirmed staff were caring, respectful and polite. One person said, 'They are like family.' Another person said, 'We are happy with the service.' A relative said, 'The level of care we contracted is being delivered, they will go above when it is required with no complaints.'
Care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain their independence. Staff knew of people's preferences, however, this was not always recorded in older care plans. New care plans were more personalised identifying people's preferences. People's religious and cultural beliefs were taken into account and recorded. This meant people's diversity and individuality were promoted and respected.
Is the service responsive?
People were treated with respect and dignity. This was confirmed by people we spoke with. A relative said, 'I am very happy they provide a standard I would expect.' Care plans had been developed and were reviewed regularly. People and relatives confirmed they were involved in changes to their care. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. A relative said, 'They are very good.'
People told us they would speak to the office if they were unhappy about anything. People were issued a 'service user handbook' that outlined the person's rights and how the service would support them. Details of the complaints procedure was contained in the 'service user handbook'. People and relatives told us they had no complaints and were confident that if they did they would be listened to.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. This was confirmed by people we spoke with and records we saw. People, relatives and staff were positive about the service and how it was led. One person said, 'It is excellent all carers are professional friendly and they come on time.' A relative said, 'They really listen, they took on board everything and there is consistency of staff.'
Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. Staff told us they loved their jobs and working for the provider. The felt confident they would be listened to. Staff comments included, 'We give a wonderful service, I have never had any complaints' and 'It is lovely I am glad to be part of the team' and 'I think they have been excellent.'
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.
The service had a quality assurance system in place. Audits and checks were undertaken regularly. This meant the quality of the service was able to continually improve.