21 May 2014
During a routine inspection
If you want to see the evidence supporting our summary please read the full report.
During our inspection we focused on our five key questions:
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
Is the service safe?
Systems were in place to make sure the manager and staff learnt from events such as complaints, concerns and investigations. This reduced the risks to people and helped the service to continually improve.
The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS), although no DoLS authorisations had been made.
The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards is law which protects people who are unable to make decisions for themselves.
Staff had been trained to understand when an application for a DoLS authorisation should be made and how to submit one. This meant people would be safeguarded against unlawful restriction and restraint if required.
We found that people were cared for in safe and accessible surroundings that supported their health and welfare. We found that appropriate checks had been undertaken by qualified professionals and the property was safe.
We spoke with the registered manager during our inspection as we observed that some areas of the home were in need of re-decoration. We also noted some furniture was in need of replacement.
We were informed that major refurbishment work to the home was due to commence on 16 June 2014. We also viewed the plans for the proposed work.
We discussed possible disruptions this might cause people who lived in the home, relatives and staff working there. We were assured that risk assessments would be undertaken and that copies would be sent to the Care Quality Commission for us to review.
These risk assessments would ensure that people, staff and visitors had been protected against the risks of unsafe or unsuitable premises.
Is the service effective?
People's health and care needs were assessed. People, and where appropriate, their relatives, were involved in reviewing their care plans. Specialist dietary requirements, mobility and equipment needs had been identified in care plans where required.
We looked at people's care records which showed that care plans set out people's individual care needs. They were current and the records showed they had been reviewed on a regular basis and adjustments had been made when a person's care needs changed.
During our inspection we observed that members of staff knew people's individual health and wellbeing needs. We saw that people responded well to the support they received from staff members.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when they supported people. One person we spoke with told us: 'I would recommend the place. The staff do their best and are good at their jobs.'
People who used the service, their relatives and friends completed a satisfaction survey every three months. Where concerns or comments were raised these had been addressed and an action plan was in place.
People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Records showed people had access to a range of healthcare professionals some of whom visited people at the home. These included GPs, district nurses, dieticians and a chiropodist.
Is the service responsive?
The provider had a complaints policy in place and information on how to make a complaint was displayed in the home. There was written information in people's bedrooms on how to make a complaint within the service user guide, should people or their relative wish to raise a concern.
Staff had received training on how to manage complaints during their induction to their role and were able to tell us how they would escalate any concerns raised.
People completed a range of activities in and outside the home on a regular basis. A new activities co-ordinator had been recruited. We saw evidence that they had a positive impact on how the activities were planned and delivered in the home.
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.We saw evidence of this in people's care records when the provision of people's care was planned and reviewed. These reviews involved social workers, district nurses and dieticians.
The service had a quality assurance system and we found records showed that shortfalls were addressed promptly. As a result the quality of the service was improving.