An adult social care inspector carried out this inspection. We spoke with the three people who used this service and inspected their care records. We spoke with two staff members and inspected two recruitment files. We spoke with the registered manager. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well led? Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and what the records told us.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
There were enough staff recruited to ensure people's care needs were met. Where people had health care needs there were arrangements in place to meet these, for example, people were visited by a community nurse where needed. There were arrangements in place to manage emergencies. These included staff knowing what to do in the case of people's individual illnesses or accidents. People's care needs were assessed and care plans were devised to ensure staff knew how to meet a person's needs safely. One person said, "It all works very well."
Robust policies and good staff awareness on subjects such as how to protect people from abuse and who to contact outside of the service, if they had concerns, helped to ensure people's safety. This was further enforced through the use of good staff recruitment practices. People told us they felt confident to be able to talk about any concerns they had. One person said, "I could tell (registered manager's name) anything and they would sort it out".
Is the service effective?
The service ensured there were suitably qualified and experienced staff on duty to meet people's needs. This was achieved through the appropriate recruitment of staff and by maintaining a good skill mix within the team.
Is the service caring?
People were supported to make their own decisions relating to what care they required and how this would be provided. One person said, "You feel you are being treated well and they maintain my dignity."
We observed staff knocking on people's doors or ringing their front door bell before entering people's accommodation. This showed that people's personal space was respected and people's privacy was maintained.
Staff had taken time to find out people's specific preferences and wishes and these had been incorporated into people's care plans and into the practical support/care they received.
Is the service responsive?
Staff followed people's written and agreed care plans which meant people received individual care that met their personal needs.
Although the service had not received any complaints since it started in July 2013 there were arrangements in place for complaints to be made, listened to, taken seriously and investigated. People had been given information on how to make a complaint about how their personal care had been provided to them if they needed to. Arrangements described by the registered manager on how complaints were investigated in other locations owned and managed by the provider told us that the provider wanted to learn from the complaints received.
The same proactive arrangements were in place for learning from incidents and accidents. Two examples were given to us of incidents that had happened in other locations, but where the provider had shared this information, which then resulted in action being taken in the Cheltenham service in order to prevent a reoccurrence.
Risks to people were effectively managed so that they could remain independent. We found two examples of where risks to people had been managed well. One included managing the potential risks of a person slipping or falling and another involved the person's personal safety when out walking.
Is the service well-led?
Both the people who use the service and the staff told us the registered manager had an open door policy. One person said, "I honestly say I have no complaints." This person went on to explain that if they did have a complaint they would make it to the registered manager and they had confidence in the fact that the complaint would be sorted out.
Staff told us the registered manager was approachable and very supportive. The registered manager told us they were aware of what was going on in their service, not only by the use of checks and audits but by engaging on a daily basis with staff and people using the service.
The provider also had arrangements in place to assess and monitor the standard of care and services being provided. This was done through visiting the service monthly, by asking people for their view on the services provided. By checking the audits completed by the registered manager and by having arrangements to ensure that any subsequent required action to improve the service had been completed.
Staff told us they were clear about their roles and responsibilities. Where issues arose these were escalated and actioned appropriately. There was a robust quality assurance system in place which ensured the service remained safe and provided services to a good standard.