8 June 2016
During a routine inspection
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The person who used the service and their relatives told us they were cared for safely. Staff had completed training in safeguarding people from abuse and records showed any concerns raised were acted on appropriately. Staff understood how to report any concerns and were aware of how to protect people from the risk of abuse.
Risk management plans provided guidance for staff on supporting people safely and minimising risks to them and others. Other health and social care professionals were involved in supporting staff and people to manage risks so that people were cared for safely and appropriately.
There were enough staff available to meet the person’s needs and care for them safely. Agency staff were used to cover staff vacancies and wherever possible the same agency staff were used to provide consistency of care. The person told us they were satisfied with the staffing arrangements. The provider carried out the required pre-employment checks to protect people from the employment of unsuitable staff.
The person’s medicines were managed safely. Staff were trained and assessed as competent to administer people’s medicines.
Staff had completed appropriate training to meet people’s needs. Staff told us they were supported and received regular supervision with the registered manager. However, staff had not always received an annual appraisal in line with the providers’ policy. Appraisal is a periodic meeting held with a supervisor to review staff performance and plan development objectives for the following year. There was a risk that people could receive care from staff who may have required additional training and development in order to provide effective care.
We looked to see if appropriate arrangements were in place to ensure that people’s legal rights were protected by the implementation of the Mental Capacity Act 2005 (MCA). The MCA sets out what must be done to make sure the rights of people who need support to make decisions are protected. The one person receiving personal care at the time of our inspection was able to make their own decisions about their care and treatment. Staff had completed training in the MCA and Deprivation of Liberty Safeguards (DoLS) and were able to describe the process they would follow if a person lacked the capacity to make their own decisions to ensure people’s human and legal rights were respected.
Staff were aware of people’s nutritional needs and how to support people to eat a healthy balanced diet. The person was satisfied with the support they received with preparing meals and drinks. People were supported to access healthcare as required and to maintain and improve their health.
The person and their relatives told us staff were kind and caring and staff knew about people’s preferences and interests. The person said staff were ‘respectful’ and staff we spoke with understood how to provide dignified care in line with people’s choices.
People’s care plans were person-centred and included information about their needs, preferences and abilities. Where people’s needs changed these were updated on their care plans so they continued to receive appropriate care.
The person confirmed they were able to talk to the registered manager and staff if they had concerns. A complaints procedure was in place and available to people in an accessible format, such as easy read and pictorial where required.
Staff confirmed the registered manager was available to them for support as required. The person told us the registered manager visited them in their home on a regular basis. Staff told us how they demonstrated the provider’s values in their work with people and the person told us they were “happy and well looked after” by staff.
A system was in place to monitor the quality of the service and this included feedback form people and their relatives. An improvement plan was in place and acted on to drive continuous improvements to the service people received.