Archived: The Causeway

' 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. The summary is based on our observations during the inspection, discussions with people using the service and the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service caring?

People were supported by kind and responsive staff. We saw that relationships were very positive. Staff showed interest in people and took time to communicate using ways that were meaningful to people. We saw that staff were respectful in their interactions with people.

Is the service responsive?

We saw from records that people were supported to have access to other health and social care professionals as necessary and that staff followed the advice given by these professionals. This meant that the service was responsive to people's health and social needs. We saw that the service was responsive to people's emotional needs. For example, we saw that the service was flexible and adapted to meet the needs of people who required changes in their environment. This meant that the service was responsive to people's individual needs and took steps to ensure people's wellbeing was promoted.

Is the service safe?

The provider had a safeguarding policy which told staff what action to take if they suspected abuse was happening. Staff understood their responsibilities in relation to protecting people from abuse and had confidence in the management that they would act on any concerns raised. Recent safeguarding concerns were found to have been reported and managed effectively to protect people's safety. People were protected from the risk of having their liberty unlawfully restricted because the manager had a good understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and was able to demonstrate how this related to the service. We observed that staff were not forceful with people and were checking people's reactions to the support they offered to ensure that they were at ease. The recruitment process used by the service and the checks that were in place before staff started work ensured, as far as possible, that people were supported by staff who had the right skills and experience and were of good character. This upheld people's safety.

Is the service effective?

We found that people were supported to participate in meaningful activities and to be valued members of the local community. We saw evidence that staff worked hard to involve people in making meaningful choices by using various communication aids that suited each individual person's needs. We saw from records that, where people had been formally assessed as lacking the capacity to make certain decisions for themselves, decisions were made in their best interests in consultation with either family members or independent advocates. This meant that people's human rights were upheld.

Is the service well led?

We saw that care plans and risk assessments were regularly reviewed. This ensured that people received care that was appropriate to their current needs. Staff told us they felt well supported. We saw that good systems were in place to support staff to communicate well with each other on shift. This helped to ensure that people received consistent care. There were systems in place to audit the quality of the service and to report and monitor accidents and injuries. This meant that the service was able to learn from adverse events and take action to make improvements when necessary.

People's nutritional needs were assessed and, where necessary, support from specialist services had been sought so that people's health was maintained.

The provider had put in place an effective system for managing the cleanliness and infection control within the service. We observed the home was clean and free from any preventable odours.

The two staff we spoke with were knowledgeable and confident in their job role and able to demonstrate a good understanding of the care people required. Information we saw demonstrated that people were cared for by a consistent and skilled staff team who understood their needs.

The manager informed us that since our last inspection in November 2012 the home had not received any complaints. We did see letters and cards that both relatives and healthcare professionals had written to the home complimenting it on the service it provided and thanking the staff for their care, professionalism and kindness.

Staff told us that when on induction at the home they were able to work supernumerary and were given time to read each person's plan so they could manage the care of the people as they preferred it.

The provider had a policy in place to ensure that all reasonable steps had been taken to protect people from potential abuse and the records confirmed that staff had received training on safeguarding awareness.

The staff told us that they felt supported by the senior care staff and the registered manager responsible for the home.

The provider had robust systems in place to collect information about the quality of the service with monthly reports being completed that identified any areas that required addressing.