20 May 2014
During a routine inspection
A single inspector carried out this inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found:
Is the service caring?
We saw people were being supported by kind and attentive staff. We observed people using the service smiling and making regular eye contact with staff. One relative told us 'the team does not put on any airs or graces when I visit, they are just their normal selves which is being kind and helpful."
We saw that care workers were patient and gave encouragement when supporting people. We heard one staff saying 'come and choose the cereal you want, when you are ready.'
We saw different types of communication regularly being used between staff and people using the service. Communication included hugs, smiles and holding hands. A relative wrote "the home has friendly staff who provide excellent care."
Relatives told us they were encouraged to get involved in the home's social activities. One relative told us 'they regularly phone or email me to tell me what is going on.'
We observed staff knocking on people's bedroom doors before entering and then keeping the door closed whilst providing personal care. All the bedrooms had en-suite bathroom facilities. This environment helped to maintain people's privacy and dignity.
Is the service responsive?
The care files confirmed people's preferences, interests, aspirations and individual needs had been recorded and the support had been provided that met people's wishes. Two relatives told us that people 'were treated as individuals.'
The ways people expressed their likes and dislikes had been recorded so that staff could understand people's wishes. A relative confirmed that she had been asked to help staff identify the likes and dislikes of their daughter who using the service.
People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives. Relatives told us that people's keyworker contacted them on a regular basis to discuss any changes to care and support.
Relatives were involved in contributing towards people's annual care review and their views were taken into consideration. One relative said 'the key worker rings me up every other week to tell me something about my daughter or to ask my opinion.'
People could make choices. We regularly heard staff asking people to make a choice. One staff asked a person to 'come and choice which yoghurt to want.' Whilst the visiting professional said one person kept joining and leaving her art group but that was absolutely fine for them to do it 'because they are expressing choice.'
Is the service safe?
We found the home safe at the point of entry. To enter the home we had to ring, wait for the door to be opened, we signed in and signed out.
People were cared for in an environment that was safe, clean and hygienic. We found the environment in good decorative order and the equipment we tested in good working order. One relative wrote "the home has a relaxed, safe environment."
We saw from the completed records that equipment at the home had been well maintained, serviced regularly and therefore safe for people to use.
Relatives told us there were enough staff on duty to meet the needs of the people living at the home. One relative told us that if she planned for a person to go on a trip out with her, the staff were made available to maintain the person's safety in the community.
Staff we spoke with were able to tell us what action they would take if they saw abuse taking place and where to find the correct contact information and procedures. One staff told us 'I treat people here as I like myself to be treated.'
The staff carried out a range of health and safety checks to ensure people were kept safe. Records showed that fire drills were carried out and that people had their personal evacuation plans.
People ate food which had been safely supplied and prepared. The catering facilities had been assessed by an environmental health officer and were given the top star rating. The kitchen records which we checked were up to date and equipment was in good working order.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards which apply to care homes. The Deprivation of Liberty Safeguards are in place to protect people's human rights. The records showed us that the manager was submitting Deprivation of Safeguards applications for all the people in the home, who because of their vulnerability could not leave without staff escorting them into the community.
Is the service effective?
People's relatives told us that they were happy with the care they saw and felt people's needs had been met. One relative told us 'the manager and staff always put the residents first.'
Relatives we spoke with said they saw staff treating people as individuals. One relative wrote " staff have a very good knowledge and the management is efficient."
Staff accompanied a person using the service and their relatives to a conference which gave a further understanding into the person's condition.
A relative confirmed that when she came up with a suggestion in changing an environmental issue, with perseverance the change was made. The home was responsive and supportive to the idea but it took time to get the organisation to implement the suggestion.
Is the service well-led?
The manager was registered with the Care Quality Commission as the registered manager for the service. One relative told us 'the manager really listens to what I have to say.' The visiting professional also said 'the manager is responsive and supportive.'
The training chart we viewed and the staff confirmed that they had received regular training to meet the needs of the people living at the home. The staff regularly updated their training and new staff told us they had done their common induction standards training in care.
The home had a range of quality control processes in place. The records needed for the safe and smooth running of the home were in good order and up to date.
People's relatives were included in how the home was run by being asked annually for their feedback on the service. Nearly all the people's relatives had filled in the home's satisfaction survey. Relative's views had been listened to and as a result of the survey, changes had been made where required. One relative wrote they "found the staff very adaptable." Staff told us their views were heard and changes could be made to how the service was run.
We found the home was well equipped. For instance the sensory room was well set out and contained a range of different furnishings. The kitchen was well stocked with adaptive equipment and a variety perishable goods, which meant that through good stock control, people were offered a range of choices.