5 September 2014
During a routine inspection
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
This a summary of what we found:
Is the service safe?
Staff we spoke with were able to demonstrate an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards. The MCA provides a framework to protect people who may lack capacity. The manager told us one person had been subject to a best interest decision and that this had been recorded in their care file. We looked at this decision and saw that it had been completed and signed appropriately.
People using the service were safe because we saw risk assessments were in place for example, physical aggression, vulnerability and medication. These had been completed recently in the care file we looked at.
We spoke with three staff members who were able to demonstrate knowledge on obtaining consent from people who used the service prior to any activity. On staff member told us, 'I ensure they [people who used the service] were happy with everything. If they said no it would depend on what it was. If it was detrimental to them I would keep revisiting it'.
Is the service effective?
All staff we spoke with confirmed they received training that was relevant to their role. There were details of training undertaken in the staff files we looked at. Details included; positive handling, equality and diversity, safeguarding, common induction standards, food safety and hygiene. The manager showed us evidence of planned training dates for staff.
All the staff we spoke with confirmed they received up to date training that was relevant to their role.
Is the service caring?
With the consent of two people who were receiving care from the service we visited them at their home. We observed a relaxed and friendly banter between staff and people who used the service. People we spoke with told us they were happy with the care that they received and were complimentary about the staff who cared for them.
Care plans were person centred and detailed people's specific needs. This included pictorial care planning to aid people with specific communication needs to understand, contribute and agree with their care. Examples of care detailed included, support for personal care, family, hobbies, how to support me to be healthy and keeping safe at home. We saw care planning was reviewed regularly and had been signed and dated.
Is the service responsive?
Staff we spoke with told us they felt there was enough staff on duty to meet the needs of people who used the service. Two of the people who used the service told us there was enough staff to care for them safely and effectively. A family member for people who used the service told us they felt there was enough staff on duty to meet their needs.
The manager told us audits were carried out regularly and plans were in place to ensure these we undertaken monthly. We saw evidence of a recent audit that had taken place. Example of audits undertaken included fire risk assessment, complaints and incidents.
We spoke with two people who used the service. Both were able to tell us they had no complaints or concerns. A family member of one person we spoke with told us they had no complaints about the service but raised a concern that they wanted to discuss with manager. The manager confirmed to us that this had been discussed, dealt with and resolved immediately.
Is the service well led?
The service does not have a registered manager with the Care Quality Commission. The provider has a regulatory responsibility to ensure there is a registered manager in place to ensure people who use service are cared for by an appropriate person. We discussed this with the manager who provided us with evidence that the registered manager's application had been re-submitted to the Care Quality Commission on the day of our inspection.
Staff had access to a policy and procedure file to ensure they were kept up to date. We were told this was in the process of being updated and all staff would be asked to read this once completed. Staff we spoke with confirmed they had read the policy file.
We received complimentary feedback about the manager. A comment received was, 'She is really nice and understanding. I can go to her with any problems'.