Archived: The Hay Wain

There was a quality assurance audit in place however the system was not always effective because issues identified at the inspection had not been recognised during the monitoring and auditing process.

People continued to receive safe care. Staff had received appropriate adult safeguarding training and were aware of their role and responsibilities to protect people from avoidable harm.

Risks associated with people's individual needs, including the environment and premises had been assessed and plans were in place to mitigate any risks. Procedures were in place to report any accidents and incidents and these were investigated and acted upon appropriately.

Staff underwent appropriate recruitment checks before they commenced their employment. Staffing levels were adequate; staff had time to spend with people. People were supported to receive their prescribed medicines safely however some improvements were needed to the management and recording of medicines stock levels.

People continued to receive effective care and support. Staff received an appropriate induction, on going training and opportunities to discuss and review their work.

The principles of The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards had been applied where required. People were supported to make their own choices and their consent sought.

People were supported with any dietary and nutritional needs however mixed feedback about the food available was received. We have made a recommendation to the provider to review people’s meal time experience. People were supported appropriately with their health care needs and the staff worked well with external healthcare professionals following any guidance and recommendations made.

Care plans were individualised and person centred focussing on people's assessed needs. Plans were reviewed and evaluated regularly to ensure planned care was current and up to date.

People had access to activities however the registered manager had recognised that further improvements could be made and plans were in place to implement these changes.

The service had a clear complaints policy that was applied when issues arose. The registered manager was involved in monitoring standards and promoting good practice.

At the last inspection on the 7 March 2013 we identified moderate concerns with care and welfare, and minor concerns with supporting workers and the quality and management of the service. During this inspection we saw some improvements had been made but further improvements were required.

Care plans had been reviewed and told staff how to meet people's needs but gaps were identified which could mean that people would not get their needs met.

Staffing levels were adequate to people's needs on the day of inspection but gaps in record keeping meant we could not always see who was on duty and whether staffing levels were always appropriate to people's needs.

Systems were in place to make sure only suitable staff were employed to work at the service but staff were not appropriately supported or developed so we could not be assured that poor practice would be identified or staff were developed and their skills utilised.

The service had some systems in place to measure and monitor the quality of the service they provided but this required improvement.

One person told us that, 'Staff are very, very good. They check on me every half an hour or so and get me everything I need.' Another person told us, 'The place is spotlessly clean; staff are attentive, all very good.' At lunch we spoke with three people. They told us they were concerned that good staff were leaving the service and that staff turnover was high. People using the service told us that some staff spoke poor English and it was difficult to understand them. Nevertheless, one person said, 'There is always some one on who knows what my needs are. '

Care plans did not accurately reflect people's individually assessed needs. Some people told us that their social needs were not met and we found there were inadequate arrangements in place to do so.

There were systems in place to ensure the environment was safe for people to live in and regular audits were carried out to ensure people's safety.

There were systems in place to ensure medication was stored safely and administered according to the prescriber's instruction.

Staffing levels were adequately maintained but we could not be assured that staff were all familiar with people's needs.