13 August 2014
During a routine inspection
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, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
This visit was unannounced, which meant the provider and staff did not know we were coming. At the last inspection in 13 May 2013 the provider met all the requirements we looked at.
Sidegate Lane Residential Home is a care service for up to 30 older people who may be elderly, have a physical disability or be living with dementia. It does not provide nursing care. At the time of our inspection there were 28 people who used the service.
A registered manager was in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law as does the provider. We received positive feedback from people who used the service, relatives, staff and health and social care professionals. They told us that the manager of the service was well established in their role, was approachable and provided clear and consistent leadership.
People who used the service that we spoke with told us they felt safe, were treated with kindness, compassion and respect by the staff and were happy with the care they received.
Staff knew how to recognise and respond to abuse correctly. People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Any risks associated with people’s care needs were assessed and plans were in place to minimise the risk as far as possible to keep people safe.
CQC monitors the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals.
We found the service was meeting the requirements of the DoLS. The registered manager had a full and up to date knowledge of the MCA 2005 and DoLS legislation, and when these applied. Documentation in people’s care plans showed that when decisions had been made about a person’s care, where they lacked capacity, these had been made in the person’s best interests. This meant that people who could not make decisions for themselves were protected.
There were sufficient numbers of suitably skilled staff to meet people’s care needs. In line with the provider’s policy and procedures newly employed staff received an induction and training. Records showed that staff received ongoing training, regular supervision, an annual appraisal and opportunities for professional development.
We looked at people's care records. The records seen showed that care and treatment was planned and delivered consistently to ensure people's safety and welfare. Information in the records was regularly updated and provided clear guidance to staff on how to meet people’s individual needs, promote their independence and maintain their health and well-being. People attended appointments with other healthcare professionals such as opticians, physiotherapists, dentists and chiropodists. This showed that people were supported to maintain their health and well-being.
The majority of people were supported to be able to eat and drink sufficient amounts to meet their needs. People told us they liked the food and were provided with a variety of meals including both hot and cold options. We found that in the main people were encouraged to be as independent as possible, where additional support was needed this was provided in a caring, respectful manner.
However not everyone had a positive mealtime experience. The lunch time meal arrangements were disorganised; not everyone who required assistance received their meal at the time it was presented, at the temperature it should have been served and without interruption.
Throughout the inspection we observed staff interacting with people in a caring, respectful and professional manner. Where people were not always able to express their needs verbally we saw that staff were skilled at responding to people’s non-verbal requests promptly and had a good understanding of people’s individual care and support needs.
We found there was a lack of organised meaningful activity to meet people’s emotional and psychological needs. It was not clear what arrangements were in place to support people to pursue their hobbies and interests and engage in planned group activities. This meant that people were at risk of social isolation.
Systems were in place which assessed and monitored the quality of the service, including obtaining the views of people who used the service, their relatives; staff employed at the service and visiting health and social care professionals. Feedback received was acted on and used to drive improvement in the service. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were managed well and that management took steps to learn from such events and put measures in place which meant they were less likely to happen again.