During our inspection we looked at whether people's privacy and dignity was respected, the way people were cared for and supported, cleanliness and infection control, the management of medication, whether there was a sufficient number of staff on duty to support people properly, and the quality monitoring systems in place. We spoke individually with three people living at the home, the senior person on duty, the housekeeper, and two members of the care staff team. Care practices were also observed during the course of the inspection.On another day we also spoke with the registered manager who was unavailable at the time the inspection visit took place.
This helped to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found.
Is the service safe?
People told us that they felt safe and secure living at the home. People we talked with spoke positively of the qualities of staff team. One person told us, 'I am very happy here, no complaints about anything. The staff are very kind and this is my home now'.
We saw that people were treated with dignity and respect. One person we spoke with gave a good example of how staff had responded positively and made it possible for her to regularly visit the grave of a relative. This was very important to this person and much appreciated.
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people were safeguarded as required.
Medication practices were in the main, robust. Only staff that had received appropriate medication training had responsibility of the administration of medication. A regular medication audit was in place. This helped to ensure that medication practices remained safe, by ensuring that any shortfall was quickly identified and addressed.
The service was safe, clean, and hygienic. Equipment had been maintained and serviced regularly therefore not putting people at unnecessary risk.
The registered manager set the staff rotas. They took into account people's care needs when making decisions about the numbers, qualifications, skills and experience required. This helps to ensure that people's needs were always met.
Is the service effective?
There was an advocacy service, soon to be made available by the new homeowners, if people needed it. This meant that when required, people could access additional support.
People told us that they were pleased with the level of care that was being delivered to them and that their assessed needs were being met. From our observations and through speaking with staff it was clear that there was a good understanding of each person's assessed needs and that personal preferences were accommodated. One person told us, 'It is OK living here. I came in for the odd stay but now I live here. I like it here'.
People's health and care needs had been assessed with them. Although some people spoken with were unsure about their current care plan, they were unconcerned by this. On the care plans we looked at, each had been signed by the person or a close relative, to confirm their understanding and agreement to the content.
Is the service caring?
People were supported by kind and caring staff. We saw that care workers showed humour, patience and gave encouragement when supporting people. People commented, 'They listen to you, care for you very well, there are no problems at all'.
People using the service and their relatives and friends had opportunity to complete satisfaction surveys. We looked at the outcome of the most recent survey, responses were mostly very positive.
Is the service responsive?
People's preferences, interests, and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
People were offered a range of activities inside and outside the service regularly. The people spoken with said they were satisfied with the arrangements in place to support social activities and social interactions. These suited people's current needs. People also told us that visitors were welcomed and that they were able to see family and friends in private and at a time of their choice.
People knew how to make a complaint if they were unhappy. However nobody expressed any complaints, only positive complements. We looked at the home's service user/family complaints procedure. This gave sufficient information about how a complaint could be made, the process of investigation, the time scale for a response, however some of the information required updating. The senior person we spoke with told us that no complaint had been made for a considerable period of time.
Is the service well-led?
The service worked well with a range of health professionals to make sure that people received their care in a joined up way.
Staff had a good understanding of the ethos of the home and quality assurance systems that were in place. This helped to ensure that the quality of the service continually improved and that people received a consistent service at all times.
The members of staff spoken with told us that they were clear about their role and responsibility and that they felt well supported by the registered manager. We were also told that the staff team worked well together for the benefit of the people living at the home.
A range of routine audits were in place including medication and fire safety. This helped to ensure that a consistent service was maintained that helped to protect people and keep them safe.