Background to this inspection
Updated
11 February 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 2 November 2016 and was unannounced.
Prior to the inspection we reviewed all the information we held about the service since the last inspection. We also reviewed all statutory notifications received since the last inspection. Statutory notifications are information the provider is legally required to send us about significant events.
One inspector carried out this inspection. During the inspection we spoke with four people who lived at the care home and reviewed four people’s care records. We also reviewed additional care records which included the medication administration records for three people. We spoke with four staff and the registered manager and reviewed two staff recruitment files. We reviewed the service’s staff training record. We reviewed the fire risk assessment and spoke to a representative of the provider about the subsequent fire safety actions completed and planned. We reviewed the service’s emergency contingency plan. We also reviewed a selection of quality monitoring audits. These included audits completed on accidents and incidents, medicines and the safe keeping of small amounts of people’s personal monies. We had a tour of the building inside and looked at the refurbishment taking place. We also looked at the garden and the condition of the footpaths leading to the exits.
Updated
11 February 2017
This inspection took place on 2 November 2016 and was unannounced.
During the last inspection which took place on 26 August 2015 people had not always been provided with opportunities for meaningful activities and interactions which met their individual needs. People’s care needed to be more personalised. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued a requirement notice for the provider to address this. The provider wrote to us and told us how and when this regulation would be met. During this inspection we found this regulation had been met.
We made one recommendation during this inspection that the provider review their quality monitoring processes to ensure they were fully effective.
The care home is registered to care for a maximum of 20 people. At the time of the inspection there were 17 people living at the care home. Care was provided to older people of whom some lived with dementia and some had mental health needs. Each person had their own bedroom with washing facilities. There were communal toilets, bathrooms, a lounge and a dining room for people to use. Some adaptions to the environment had been made to support people’s needs. The provider was continuing with a programme of refurbishment and re-decoration to improve the environment for people and to ensure it met with relevant regulations.
The registered manager had managed the care home for the last five years. 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.
There were arrangements in place to keep people safe and people told us they felt safe. Risks to individuals were identified and managed. Improvements had also been made to the environment to help with this. Where needed contracts were in place with specialist companies to assist in this. People were protected from potential abuse because staff knew how to recognise potential abuse and how to report their concerns. Where needed, staff also worked with other professionals and agencies to safeguard people. Staff recruitment processes helped to also protect people from those who may be unsuitable to care for them. Staff were provided with relevant training to be able to carry out their work safely and effectively. They had received some additional training in caring for those who live with dementia. People received their medicines as prescribed and when they needed them. The environment was kept clean and any potential infection risks managed.
People’s care was delivered to them with their consent and they were supported to make independent decisions. Where people lacked the mental capacity to make specific decisions, these were made on their behalf and in their best interests. People who lacked mental capacity were protected because the staff adhered to the principles of the Mental Capacity Act 2005. People had a choice in what they ate and drank and when they were unable to maintain their nutritional well-being staff supported them. Staff worked closely with health care professionals to ensure people’s health needs were met. People had access to specialists and were supported to attend health appointments.
Staff cared for people in a kind and compassionate way. People were respected and their dignity and privacy maintained. Those who mattered to people were welcomed, appropriately involved and able to speak on behalf of their relative. People’s needs were assessed and their care planned and reviewed with their involvement, where this was possible. Individual likes, dislikes, preferences and choices were explored with people and respected when staff supported them. Improvements had been made to provide better opportunities for people to have meaningful interactions and social activities. Staff sought feedback from people about what they wanted to do and if they wanted any changes made to how the service was run.
The management team supported each other and the staff to be able to provide people with a good service. There was an open, transparent and inclusive culture. The quality of the service, its systems, processes and staff practice were all monitored by the managers and improvements made where needed. The provider was actively involved and there were systems in place to ensure they received the information they needed. They however, needed to reassure themselves that they had appropriate process in place to review the effectiveness of the monitoring system that was in use.