15 July 2014
During a routine inspection
Is the service safe?
We saw that people were cared for in an environment that was maintained and suitable to meet their needs. One person told us, 'Staff are very kind and patient, I've never heard them shout'. Another person said, 'They look after you well'. All the people we spoke with told us they felt safe living in the home Staff spoken with and records seen showed training was provide so that people's needs were met safely. We saw that risk assessments and equipment was available to ensure that people had the right equipment to meet their needs. Risk assessments had been completed to ensure that risks to people's health were minimised.
All the people spoken with told us that staff responded quickly when they needed assistance. We observed good interactions between the staff and the people who lived there. One person told us, 'I don't have to wait for anything they come quickly, I know how to summon assistance by using my call bell. You only have to ask once and it's done.'
The provider told us that no application under the Deprivation of Liberty Safeguards (DoLS) had been made. The provider was not fully aware of the new Supreme Court ruling in relation to DoLS. We asked the provider to establish if anyone's liberty had been restricted and therefore may be subject to a DoLS application. This would ensure decisions made on people's behalf were in the individual's best interest to keep people safe.
Is the care effective?
All the people that we spoke with told us they were happy with the care and that their needs were being met. One person told us, 'It's all right here, staff are alright. The gaffer looks after you well. There is nothing wrong with this place'.
We saw that staff knew people well and were attentive to their needs whilst supporting them to be independent. One person told us,' I could not ask for better staff to help me they are all lovely.'
Is the service caring?
All the people we spoke with and our observations told us that the staff were caring. One person told us, 'There are no rules, they look after you really well'. Another person told us, 'They (staff) help me when I need help but they always ask if they can do anything.' We saw that staff attended to people needs when asked. We saw good banter with the people who lived there and sensitivity when assisting with personal care.
All the people we spoke with told us and we saw that staff respected their privacy and dignity and that they were given choices about their care. We saw that people were well presented in individual styles. One staff member told us, 'I would let my mom live here, people are looked after really well'. People were supported to attend healthcare appointments and referrals were made to other health care professional when required. One person told us, 'Staff come with me to appointments, they are very supportive and explain things if I am not sure'. This meant people were happy with their care and the provider took the appropriate action to involve other health care professional to ensure people's health and welfare was monitored.
We saw that staff were attentive to people's needs and spoke with people respectfully. We saw that staff asked people if they wanted drinks and encouraged them to make choices. A relative told us, 'There is always a pleasant and comfortable atmosphere and I see staff caring for people.' A visiting healthcare professional told us, 'Any instructions given to staff are always followed and they always seek advice.' This showed that staff cared for people and ensured that people's needs were met.
Is the service responsive?
All of the people that we spoke with told us that staff asked them if they would like to be supported with personal care tasks such as bathing. One person told us, 'The staff always ask and wait for me to give them an answer. I have never been made to do anything that I have not agreed to.' One staff member told us, 'I always ask people, 'do you want a bath or shower today and what time would you prefer'.' This meant that staff were able to provide care that met people's needs according to what they wanted on a daily basis. During our inspection, we observed staff interactions with people were caring and compassionate. For example, we observed a staff member discreetly ask a person if they could assist them to the bathroom. We also observed staff at lunchtime give people time to decide whether they wanted to be supported to the dining area or have their lunch in the lounge. This meant that staff responded to people in a personalised way taking into account how people felt.
We saw that care plans were reviewed so people's changing care needs were known so that staff had the current information so they could support people appropriately. There were no restrictions on family members visiting the home showing that the service was responsive to people's needs and enabled them to maintain relationships with people important to them.
Is the service well led?
We saw that meetings with people who used the service were held to gain their views about the service and make suggestions for improvement. All the people we spoke with told us that the provider and staff always listen. This meant the provider monitored the service and took people's views into consideration when making improvements.
All staff told us that they were able to put forward ideas and the provider would listen and try and accommodate where possible to improve the service provided to people. All staff spoken with told us they felt supported by the manager, and had regular training opportunities. This meant staff had the skills to care for people safely.
The service does not have a registered manager. Which means the provider is in breach of their condition of their registration. This condition was imposed at the time of their registration with us. We have issued a fixed penalty notice which is a fine that has been paid. We may take further action if the provider continues to be in breach of their conditions of registration.