2 April 2014
During a routine inspection
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well-led?
This is a summary of what we found:
Is the service safe?
We saw care plans included risk assessments. These were relevant to the person and specified action required to manage risks such as the risk of falls. We saw equipment, for example stand aids and walking aids, being used appropriately and in accordance with the person's risk assessment.
The environment was suitably designed, adequately maintained and fit for purpose. Bathrooms had been adapted to accommodate people with limited mobility and included bath hoists. Handrails had been installed in all corridors, to reduce the risk of people falling. Safety equipment, such as fire extinguishers and mats had been tested recently; the home's electrical and portable appliance tests were up to date; and checks of the call bell system confirmed it was working effectively.
Staff had received training in safeguarding and people told us they felt safe living at the home. One person said, 'I feel much safer here than I did at home'. However, staff had not received training in the Mental Capacity Act, 2005, (MCA) or deprivation of liberty safeguards (DoLS).The manager contacted us after the inspection to inform us that MCA and DoLS training had been arranged for July 2014. This would ensure staff have the necessary knowledge to make 'best interests' decisions on behalf of people and to know when an application to deprive someone of their liberty should be made.
Is the service effective?
We found staff had a good understanding of the people in their care and how their needs should be met. People praised the standard of care and confirmed their needs were met consistently. One person said, 'I'm very happy here. Staff are very caring and there's always someone to help you and talk things through with you'. Another person told us 'I have a bath whenever I want one and I'm really well looked after'. Care records showed people had access to appropriate medical care, including GPs, dentists and chiropodists. People's needs were clearly known and met.
Staff received appropriate induction and training. Training records showed three staff members were working towards vocational qualifications appropriate to their role and six staff members had already obtained such qualifications. This meant people were supported by staff who were suitably trained.
Is the service caring?
We observed care and support being provided in communal areas. We saw staff interacting positively with people, using people's preferred names and speaking with them in a calm and respectful way. They took time to sit and engage with people and understand their needs. We heard a staff member talking to people about their life histories and interests, and saw another painting people's nails.
Staff sought people's permission before delivering any care or support. When the cleaner entered the lounge to clean it, they checked with each person to ensure they would not be disturbed by the vacuuming. One person told us person told us 'I class [the staff] as friends; they're very patient and always help you'. A family member said, 'I'm very happy with the care here; the staff are lovely'.
Is the service responsive?
People had access to a range of activities and told us they had 'enough to do'. They said musicians and entertainers sometimes visited, which they enjoyed. One person told us about his 100th birthday party which had been arranged by the home. They said it was 'the best birthday I've ever had'. Other people said they enjoyed accessing the grounds of the home. One person said, 'I can go out anytime, but they worry about me falling, so someone always come with me'.
One person, whose mobility had recently changed, had been seen by a specialist. They had provided new equipment on the day of our inspection and we saw the manager had arranged a training session to teach staff how to use this equipment safely. Because the person was no longer able to use the standard scales, the home had purchased 'sit-on' scales, so the person's weight could continue to be monitored effectively.
Is the service well-led?
The manager told us about a range of consultation sessions they had run to seek the views of people and staff members about the service they received and delivered. These identified what was working well and what could be improved. Action was then taken to make the necessary changes. These had included improving the lighting, arranging more activities and introducing a choice of menus.
We looked at a development plan for the previous year, which we saw had been completed. The provider had recently employed an external consultant to conduct an extensive audit of the home's working practices. The manager told us they were waiting for the consultant's report, following which an action plan would be developed to address any areas of concern. These arrangements would allow the provider to monitor the quality and safety of the service effectively and make improvements where required.