Archived: Jim Gillespie House

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were protected from the risks of abuse because staff were trained in recognising and reporting any safeguarding concerns. The registered manager checked staff were suitable for their role before they started working at the home and made sure there were enough staff to support people safely. Medicines were stored, administered and managed safely. The housekeeping staff followed best practice guidance to keep the home clean.

Risks to people's individual health and wellbeing were identified with the person and their representative and care was planned to minimise the identified risks. The provider and registered manager regularly checked that the premises, essential supplies and equipment were safe for people to use.

People were cared for and supported by staff who had the skills and training to meet their needs effectively. People were supported to eat and drink enough to maintain a balanced diet that met their preferences. People were referred to other healthcare services when their health needs changed. 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 supported this practice.

People, relatives and staff felt well cared for. The registered manager and staff understood people's diverse needs and interests and encouraged them to maintain their independence according to their wishes and abilities. Staff respected people's right to privacy and supported people to maintain their dignity. People were supported and encouraged to socialise and to engage in stimulating activities. People and relatives were confident any concerns or issues they raised would be dealt with promptly.

People and relatives knew the registered manager well and were invited to share their views of the service through regular meetings and questionnaires. Staff were inspired by the registered manager's leadership, skills and experience to provide a quality service. The registered manager and provider regularly checked the quality of the service to make sure people’s needs were met safely and effectively. The service people received was in accordance with the fundamental standards of care.

Further information is in the detailed findings below.

The home provides accommodation and personal care for up to 26 older people. Twenty-four people were living at the home at the time of our inspection. There was a registered manager in post. 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 The inspection took place on 15 December 2015 and was unannounced.

The home provides accommodation and personal care for up to 26 older people. Twenty-four people were living at the home at the time of our inspection. There was a registered manager in post. 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.

Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise concerns under the provider’s safeguarding and whistleblowing policies. The registered manager assessed risks to people’s health and welfare and people’s care plans included the actions and equipment needed to minimise the risks.

There were enough suitably skilled and experienced staff on duty to meet people’s care and social needs. The registered manager checked staff’s suitability to provide care during the recruitment process.

The registered manager regularly checked that the premises and equipment were suitable and properly maintained to minimise risks to people’s safety .People’s medicines were managed, stored and administered safely.

People’s needs were met effectively because staff received appropriate training and support. Staff read the care plans and new staff shadowed experienced staff until they knew people well and understood their needs and abilities. Staff were supported and encouraged to reflect on their practice and to develop their skills and knowledge.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). For people with complex needs, their families and other health professionals were involved in making decisions in their best interests.

Risks to people’s nutrition were minimised because staff knew about people’s individual dietary requirements. People were offered a choice of foods and were supported to eat and drink according to their needs.

People were cared for by kind and compassionate staff who knew them well. Staff knew about people’s individual preferences for care and their likes and dislikes. Staff ensured people obtained advice and support from other health professionals to maintain and improve their health and when their health needs changed.

Staff were attentive to people’s feelings and behaviours and understood how to reassure them. People were supported to spend time with other people who lived at the home and to maintain relationships with those people were important to them.

People and their representatives were involved in planning and agreeing how they were cared for and supported. Care was planned to meet people’s individual needs and abilities and care plans were regularly reviewed.

People and relatives told us care staff were kind and respected their privacy and dignity. They were confident any concerns would be listened to and action taken to resolve any issues.

People and relatives were encouraged to share their opinions to enable the provider to make improvements in the quality of the service. Staff were guided and supported in their practice by a management team they respected.

The provider’s quality monitoring system included regular reviews of people’s care plans and checks on equipment, medicines management and staff’s practice. The provider’s visions and values were understood and shared by the managers and staff. The focus of the service was to ensure people enjoyed the best possible outcomes as identified in the Commission’s essential standards.

The provider’s plans to improve the quality of the service included more personalised library and medicines services and the use of time saving electronic equipment for staff.

Prior to our visit we reviewed all the information we had received from the provider. During the inspection we spoke with a total of ten people who used the service and five relatives and asked them for their views. We also spoke with three care workers, one senior care workers, the deputy manager and the registered manager. We were also able to speak to a visiting health care professional. We looked at some of the records held in the service including the care files for 12 people. We observed the support people who used the service received from staff and carried out a brief tour of the building.

The summary below describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We found that people's needs had been assessed and individual care plans drawn up to meet people's needs. These assessments and plans included consideration of risks to the person and how these could be managed to keep the person safe.

There were arrangements in place to deal with foreseeable emergencies. We were told by staff members we spoke with that they were able to contact a manager when they needed to.

People were protected from the risk of abuse because the provider had ensured that safeguarding policies and procedures were in place and available to staff. Staff had been trained in safeguarding and knew what to do in the event of abuse being suspected, witnessed or alleged.

There were systems in place to protect people against the risks associated with medicines. These systems were monitored by the provider with checks also being carried out by a pharmacist.

The provider carried out recruitment checks on new staff before they started working with people.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People told us they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. We saw people being cared for and supported in accordance with their plans. Staff had received training to meet the needs of the people living at the home.

We saw in care plans that risk assessments had been completed that promoted people's independence. We saw in care plans that where people undertook aspects of their care independently this was clearly stated. Staff members we spoke with told us they thought it was important to promote people's independence.

Is the service caring?

People were supported by kind and attentive staff. We saw staff talking with people in a kind, calm and respectful manner. We saw staff took care to ensure people had enough to eat and drink.

Family representatives we spoke with told us, "There is nothing to worry about here" and "The staff care and it shows". Staff told us, "Any equipment people need is provided straight away" and, "People are looked after really well". We were told by a staff member that, 'Staff here genuinely care, which comes from management showing they care'.

Is the service responsive?

We found that each person's needs were regularly reviewed and care plans were updated if needed. Records showed that people were supported in line with their plans.

People had access to activities and had been supported to maintain relationships with their friends and relatives.

We spoke with people who used the service about their care plans, they told us, 'I know what's in my care plan and have agreed to it' and, 'They asked me how I wanted to be looked after'.

Is the service well-led?

We found that quality assurance processes were in place. People's views had been obtained by the provider along with the views of family representatives and staff. The provider had taken action as a result.

People who lived at the home and their relatives told us they would feel able to raise any concerns they had with the provider and were confident their concerns would be dealt with.

We found that quality checks were carried out by the provider and that the health and safety of people was monitored.

We found that people consented to the care and support they received when they first moved into the home. Staff explained that people were free to accept or decline assistance or support with their everyday living. One person told us, 'It's a good place, the staff are all good.'

Risks to people's health and well being were minimised because the provider assessed people's needs and abilities when they first moved into the home. Care plans were written according to people's abilities and dependencies. Care plans were regularly reviewed and updated to reflect people's changing needs.

The provider followed the Department of Health code of practice for prevention and control of infection. Staff we spoke understood the importance of using their infection control training to guide their practice.

Two care staff we spoke with told us they felt supported because they had training and regular team and individual meetings with the deputy manager.

The provider monitored the quality of the service. The provider invited people who lived at the home and their relatives to say what they thought of the quality of the service. A relative told us, "The deputy is really good and conscientious."