17 June 2014
During a routine inspection
As part of this inspection we spoke with four people who used the service, a visiting relative, the manager, the deputy manager, the chef, a domestic worker and two care workers.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.
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?
People were treated with respect and dignity by the staff. People who used the service told us they felt safe. A person told us, "I'm very happy here. Yes I'm safe, I can't believe that they are so nice to me".
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
The service was safe, clean and hygienic. Equipment had been well maintained and serviced regularly therefore did not put people at unnecessary risk.
Policies and procedures were in place to make sure that unsafe practices were identified and people were protected.
The service had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS), although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people were safeguarded as required.
Is the service effective?
There was information around advocacy services available if people needed it, this meant that when required people could access additional support.
People's health and care needs were assessed with them, and, as far as practicable, they were involved in developing and reviewing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required.
People and their relatives said that they had been involved in reviewing care plans and they reflected their current needs. One relative told us, 'The home is always liaising with me about my [relative's] care'.
Visitors confirmed that they were able to see people in private and that visiting times were flexible.
The service had systems in place to assess and manage risks and to provide safe and effective care. Staff were appropriately trained and training was refreshed and updated regularly. We also found evidence of staff seeking advice, where appropriate, from the GP or social services.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A person who used the service told us, "The staff are really nice and so are the nurses". A relative told us, 'The staff are really good and have a good understanding of my [relative] they treat him like a grown up'.
We spoke with relatives who said they were able to visit the service at any time and they were always made to feel welcome. We saw that the staff took time interacting patiently and sensitively with people throughout the service. We observed that people were treated with consideration, dignity and respect.
People who used the service, their relatives, friends and other professionals involved with the service had completed a recent satisfaction survey. Where shortfalls or concerns were raised these were addressed.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People completed a range of activities in and outside the service. The service had a dedicated activity co-ordinator, and people told us that they had regular activities planned and occasional trips out of the service, which helped to keep them involved with their local community.
People's needs were assessed before they moved into the service and detailed and comprehensive care plans and risk assessments were maintained and reviewed regularly. This ensured that the care and support provided reflected any identified changes in people's individual needs.
We were told by the manager that the service had good systems in place to monitor its own standards of service delivery and to gain feedback from people who used the service, their relatives and other stakeholders. As well as satisfaction questionnaires, the manager told us they carried out a range of internal audits, including infection control and environmental health and safety.
People told us they were asked for their feedback on the service and their feedback was heard and changes were made as a result. People and their relatives, who we spoke with, also knew how to make a complaint or raise any issue or concern that they might have. They were also confident that their concerns would be listened to and acted upon.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care and support in a joined up and consistent way.
The service had established quality assurance systems in place and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service provision continued to improve.
Staff told us they were clear about their roles and responsibilities. Staff showed a good awareness of the ethos of the service and a sound understanding of the care and support needs of people who used the service. They told us that they felt valued and supported by the manager and were happy and confident in their individual roles.