7 September 2011
During a routine inspection
We saw from the care plans of two people that they needed specific help and supervision during meals. We observed these two people during lunch and we saw one person had care delivered as specified in their care plan. The second person did not appear to be getting the supervision that was specified in the care plan. The care plan had records and risk assessments that stated there was a nutritional risk and asked that this person be weighed monthly, have their food cut up and be supervised during their meal with support and encouragement offered. These instructions were not followed during the meal and this person was not being weighed weekly on a regular basis. We spoke to three staff and the manager about this persons nutritional needs and they all told us that this person would eat less if they were supervised and if their food was cut up as they were very private and independent. This information had not been communicated in the persons care plan and so it would be unclear to new staff how this person's nutrition would need to be managed.
The people we spoke with told us that if they did not feel safe, they felt they could speak with the manager about this and it would be acted on. However, none of the people we spoke with were aware of how to make a complaint if they didn't feel the manager had acted on their concerns.
One person using the service has a prescribed fortified powder mixed into their drink to help to maintain their weight. One member of staff told us that this person would not drink the liquid if they knew the prescribed powder was mixed in and so they mixed it in without the person's knowledge. If the fortified powder is being mixed into the drink without the person's knowledge this could be classed as 'covert administering of medicines.' We did not find any evidence of an agreement from the persons General Practitioner (GP) or a best interest assessment within this persons care plan. These should be in place if medication is being administered covertly.
We spoke with five people using the service about the staff. We received positive comments such as, 'the staff are good', 'Can't grumble about the staff' and 'no complaints, the staff are very good.'
We also some observed positive interactions between staff and people using the service.
Two people using the service told us that meetings take place for people living in the home and said that they had attended the meetings. They told us that they felt their views were listened to and would be acted on.
We saw the minutes of the last meeting held for people using the service and we saw that they had been kept up to date with what was happening in the home and to raise any concerns they may have.