23 December 2015
During a routine inspection
This inspection took place on 23 December 2015 and was unannounced. The home provides accommodation for up to 11 people, over the age of 65 who may be living with dementia or mental health needs. There were 11 people living at the home when we visited. This was the first inspection for this service since it was registered in November 2014.
The service had a registered manager who was also the provider. 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.
Precious Care Home provides communal areas, a dining room and separate lounge and kitchen on the ground floor. There were bedrooms on the ground floor, first floor and one bedroom and the manager’s office on the second floor. One of the rooms on the ground floor was a shared room, as was one on the first floor. All floors were accessed by the use of a stair lift or the stairs. There was a well maintained garden area at the rear of the service which people were able to access.
People were not always kept safe. Emergency plans were in place, but kept in a room which was not easily accessible in the event of an emergency. Checks had not been completed on the water system within the home to make sure the temperatures were correct and there was no contamination from Legionella. All other environmental checks were being carried out.
Recruitment processes had not been followed. Records showed full employment histories had not been collected, but all other necessary checks had been completed. Staff received appropriate training and were supported through the use of one to one supervision and appraisals.
The provider had failed to notify CQC about one incident but had taken appropriate action to prevent this incident occurring again.
People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the individual needs of the people and knew how to spot signs of abuse. People said they felt safe and supported by the care staff and provider. Medicines were managed safely and people received their medicines as prescribed.
People felt involved and listened to. They contributed to what was written in their care records and risk assessments. These were kept up to date and were an accurate reflection of the person’s care and support needs. The care plans included the person’s likes and preferences and were reviewed regularly to reflect changes to the person’s needs. People had access to healthcare services and were referred to doctors when needed.
The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA). Staff gained consent from people where appropriate. Staff understood about involving the local authority when considering depriving someone of their liberty. They knew that they had to look at what was in the person’s best interests and how to protect the person in the least restrictive way.
People said the registered manager and staff were caring and felt they could go to them about anything and actions would be taken. Staff spoke to people in a kind, respectful and caring manner. There was an open, trusting relationship between them, which showed that the staff and provider knew the people well. Staff were offering people choices and respecting their decisions appropriately. People and their relatives were positive about the service they received. They praised the staff and care provided.
People had been consulted when decisions were made about what activities they wanted within the service. Changes had been made to accommodate their choices and people could do as little or as much as they chose to do.
People and their relatives were able to complain or raise issues on an informal basis with the registered manager and were confident these would be resolved. The manager demonstrated a good understanding of the importance of effective quality assurance systems. There was a process in place to monitor quality and to understand the experiences of the people who used the service. There was regular contact between the provider, manager, people, relatives and the staff.