Archived: Seva Care Home

At the last inspection in October 2015, the service was rated Good. At this inspection we found the service remained Good.

Risk to people who used the service had been assessed, updated and regularly reviewed to ensure people were safe and the identified risks were minimised. Staff had received safeguarding adult training to ensure they took appropriate actions if people who used the service were at risk of harm and abuse. They understood the reporting procedures. There were sufficient staff deployed to meet people’s needs and safe recruitment practices were followed. Medicines were managed safely and staff were appropriately trained. Appropriate infection control procedures were followed to minimise the risk of spreading infection. Accidents and incidents were documented and audited by the registered manager to find trends and prevent future incidences from happening.

People’s needs were assessed to ensure that the service was able to provide treatment or care appropriate to people’s needs. Staff were provided with ongoing training and regularly planned supervisions and appraisals. This ensured their performance was monitored and they were supported to care for people using the service and meeting their assessed needs. People were offered with a varied, healthy and culturally appropriate vegetarian diet, which was provided freshly every day. People had access to health care services and clinical advice was sought to ensure people’s health and well-being. People lived in a well maintained home and regular decorations were carried out to ensure a nice and comfortable living environment. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service support this practice. The service operated within the principles of the Mental Capacity Act 2005 (MCA).

People we spoke with were complimentary about the staff and the service in general. We observed interactions between staff and people living in the home to be warm and friendly. Staff supported people in a kind and compassionate manner.

Staff knew people's likes, dislikes and social histories. Care plans contained good information regarding people's preferences, likes and dislikes. People had access to a range of activities, but also told us that they enjoyed their own company. People had access to a complaints procedure which provided relevant contact details should people wish to make a complaint. Wishes how people chose to be supported at the end of their life formed part of their care plan.

Arrangements were in place to seek the opinions of people who lived at the home, so they could provide feedback about the support they received. Annual surveys and questionnaires were issued to capture people's views regarding the service. The home had a registered manager in post. We received positive feedback about the registered manager from staff, people who lived at the home and their relatives. A range of audits and checks to assess and monitor the quality of the service ensured the quality of treatment and care was improved.

Further information is in the detailed findings below.

Seva Care Home is a care home for eight Asian older people. The home is located in a residential area in Harrow North West London. During the day of our inspection seven people were living at Seva Care Home.

The home had a registered manager employed who was on annual leave during the day of our inspection. 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 staff of the service had access to the organisational policy and procedure for protection of people from abuse. Staff said that they had training about protecting people from abuse, which we verified on training records and these staff were able to give detailed responses about the action they would take if a concern arose. Staff understood how to keep people safe from harm and this knowledge helped to protect the people using the service.

We saw that risks assessments concerning falls, healthcare conditions and risks associated with daily living and activities were detailed, and were regularly reviewed. The instructions for staff were clear and described what action staff should take to reduce these risks and how to respond if new risks emerged.

There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. The service was applying MCA and DoLS safeguards appropriately and making the necessary applications for assessments when these were required.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way. People using the service had complex needs and we found that the information and guidance provided to staff was clear.

It was clear that significant efforts were made to engage and stimulate people with activities whether these are day to day living activities or those for leisure time. One to one time was provided for people to maximise their opportunities to engage in normal life experiences.

Everyone we spoke with who used the service, and relatives, praised staff for their caring attitudes. The care plans we looked at showed that considerable emphasis was given to how staff could ascertain each person’s wishes including people with limited verbal communication and to maximise opportunities for people to make as many choices that they were meaningfully able to make. We saw that staff were approachable and friendly towards people and based their interactions on each person as an individual, taking the time needed to find out how people were feeling and what they could do to help.

Staff views about the way the service operated were respected as was evident from conversations that we had with staff and that we observed. We saw that staff were involved in decisions and kept updated of changes in the service and were able to feedback their views at handover meetings, staff team meetings and during supervision meetings.

The service complied with the provider’s requirement to carry out regular audits of all aspects of the service. The provider carried out regular reviews of the service and regularly sought people’s feedback on how well the service operated.

We spoke with six people who used the service, the registered and deputy managers, the provider, two staff members and two family members. We spoke with people using a translator. We reviewed the care plans for two people.

This is a summary of what we found:

Is the service safe?

Systems were in place to ensure that staff learnt from events such as accidents and incidents. This reduced the likelihood of people being at risk. We saw systems were in place to protect people against the risks associated with medicines.

During our inspection we assessed how the Mental Capacity Act (MCA) 2005 was being implemented. This is a law which provides a system of assessment and decision making to protect people who do not have capacity to give consent. We also looked at Deprivation of Liberty Safeguards (DoLS). DoLS aim to make sure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom. We saw some people were unable to leave the home without the assistance of staff. This may mean deprivation of liberty authorisations were required. On the day of inspection the registered manager told us no applications for a DoLS had been made. After the inspection we were emailed one DoLS application dated August 4th 2014.

Is the service effective?

Staff assessed people's health and care needs with the person and their family members. Care plans assisted staff to meet people's needs, through the provision of information on people's choices and preferences as well as any limitations. We saw the information in care plans included risk assessments and care plans.

Staff received supervision and appraisals and were provided with feedback on their performance. Staff were able to identify training and development needs in order that they could deliver the care and support people effectively.

Is the service caring?

All the people told us they felt safe in the care of staff. We observed staff showed patience and gave encouragement when supporting people. One person said, 'All the staff are good and look after me. They ask us questions now and again and I answer what I want.' Two people told us staff were 'All-right,' two people said they were 'OK' and one person said they (the staff) were, 'Good.'

People told us they could speak with staff if they had concerns or were unhappy about their care. One person said, 'Everyone is good, they look after me and are concerned about me.' Another person said, "Staff look after me.'

Is the service responsive?

People took part in activities within the home such as playing board games. People's preferences, interests and diverse needs were recorded, and care and support was provided in accordance with the wishes of people using the service and their families. For example, people told us about religious 'sing-alongs' which they participated in.

People we spoke with knew how to make a complaint. We saw there was a process in place to respond to any issues of concern.

Is the service well-led?

This small service had quality assurance systems in place. These helped the staff to identify and address issues. People were asked to comment on the service while family members were given a questionnaire to complete. Staff we spoke with were clear about their roles and responsibilities.

People who used the service told us, 'It's lovely. Like home", and 'Everything is so good here. What else can we say?' We saw that people and their representatives were involved in the planning of their care and that daily record sheets were kept and care plans were regularly reviewed.

We saw that the food served to residents was cooked fresh, met their individual dietary requirements and was served in sufficient quanitities. We saw that people's weight was regularly monitored and recorded however, appropriate action was not always taken when significant weight loss was detected.

The provider had recently sent out satisfaction and feedback forms to people and their representatives. The home undertook regular audits and had policies in place to safeguard people against foreseeable risks. However, once information was recorded it was not always clear what was to be done with it.

We looked at the care plans of two people and found that care was planned so people's care needs were being met. We spoke with members of staff who had a good understanding of how to deliver people's care and this was done in line with the person's care records. We also looked at how people's medication was stored and administered and found that people were protected from risks of harm as there were appropriate systems in place to manage people's medication properly.

We looked at staff recruitment records and found the service only employed people who are suitable to work in the home. People had relevant checks carried out prior to being employed which meant that the risk of inappropriate staff being employed was reduced.

We looked at how the service managed complaints and found that people were supported and encouraged to make complaints where they had concerns, and these were dealt with appropriately by the provider.