During the inspection there were 35 people using the service. We spoke with three people who used the service and four relatives and asked them about the care they or their family member received. We carried out a tour of the building and reviewed records relevant to the running of the service. We observed staff interaction with people throughout the home. We spoke with the manager, care manager, district manager, four team leaders, two care assistants and two district nurses. At the time of the inspection the manager had applied to become registered with the CQC. We will monitor their application to ensure it is completed in a timely manner.
Throughout this inspection we focused on these five key questions; is the service safe, effective, caring, responsive and well-led?
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People received care in an environment that was safe. The communal areas, gardens and bedrooms that we looked at within the home were clean and tidy.
We saw people received their prescribed medication and this was handled and stored safely. We observed staff administer people's medication in a safe manner whilst ensuring they respected their wishes and maintained their dignity at all times.
The CQC monitors the operation of the DOLS which applies to care homes. DOLS are part of the Mental Capacity Act 2005. Correctly applied DOLS make sure that people in care homes are looked after in a way that does not inappropriately restrict their freedom. The safeguards should ensure that care homes only deprive someone of their liberty in a safe and correct way, and that this is only done when it is in the best interests of the person and there is no other way to look after them.
The care manager told us they planned to assess each person who used the service to establish whether they believed a DOLS would be required. If so, they would ensure the assessment was conducted and applications sent to the authorising body in a timely manner.
Staffing levels had been increased since the last inspection. There were now enough qualified, skilled and experienced staff to meet people's needs and to keep them safe.
One person who used the service told us, 'I feel safe here, no worries at all. I have no problems. The staff are very caring and very helpful, nothing is too much trouble for them.'
Is the service effective?
We saw improvements had been made since the last inspection. People's capacity to make their own decisions had now been formally assessed where required and the documentation was recorded in their care plan.
Improvements had also been made in relation to the documentation regarding cardiopulmonary resuscitation more commonly known as CPR. However further improvements regarding some of the documentation was required .
People were consulted on decisions relating to their care. People we spoke felt included and relatives we spoke felt their opinions and views on decisions regarding their family member were welcomed.
One person who used the service told us, 'I am pretty much free to decide what I want to do and what I want the staff to do. I would give the staff top marks." A relative we spoke with told us, "The staff talk to me each time I'm there, they welcome my input.'
A district nurse we spoke with told us they were confident that advice and guidance they gave staff to effectively manage people's care was implemented. They told us, 'I am here every day and have no concerns; people are safe from what I see. The staff seem to know what they are doing. When I have given advice they have followed it.'
Is the service caring?
We spoke with relatives of people who used the service and asked them if they felt their family member was safe and well cared for by the staff. One person told us, 'The last six months have seen a vast improvement. The carers are brilliant, they get on really well with people, they do seem to really care.'
We observed staff interact with people who used the service. They were caring and attentive in their approach and did not rush people. They observed people's dignity and wishes at all times. We observed two activities taking place; a church service in the morning and arts and crafts in the afternoon. During both of these activities people were treated with respect by all staff.
Is the service responsive?
We saw staff respond to people's needs throughout the inspection. We did not see people left for long periods without interaction from staff. When people needed help, staff were there to assist them.
We saw management had responded to a person who had recently started to regularly fall out of bed by requesting a meeting with their relative to discuss the use of bed rails being added to their bed. These were implemented. However, it was noted that an assessment, known as a mental capacity assessment, had not been conducted to assess whether the person could contribute to the decision about the bedrails themselves.
The management welcomed people's views and responded to them. Questionnaires had been issued to people who used the service and their relatives. The responses received were positive. However, when asked, the management could not provide the analysis of these results to show how they planned to use the results to improve the service. We were told these would be forwarded to us.
Is the service well-led?
We asked people who used the service, their relatives and staff whether they felt the service was well led by the management team. A person who used the service told us, 'The new manager seems lovely.' A relative we spoke with told us, 'I think this is the best care home in the area. I went to see them all before this one. The new care manager is great. If I have any concerns I can raise it with them.'
We saw improvements had been made since the last inspection. We saw there were now regular audits in such areas as care plans, medication and infection control. Regular supervision and observation of staff performance was now conducted and recorded.
Staff spoke positively about the new management team. One staff member told us, 'The management are brilliant, you can have a laugh with them, they have fitted in really well.' Another staff member told us, 'Since the new manager started we have become more of a unit now. Now we have a settled manager things have settled down and we work as a team.'