Archived: 34 St Ronans Road

At the time of the inspection there was a registered manager in post. 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.

People were safe. Systems were in place to manage risks to people, visitors and staff. Health and safety checks were conducted to ensure the safety of the premises and the environment. Staff knew their responsibilities and how to respond to any safeguarding concerns. They felt any concerns would be taken seriously and acted upon by the managers of the service.

A robust recruitment procedure helped to ensure suitable staff were employed at the service to support people. People received their medicines safely and when they required them.

There were sufficient staff to meet people’s needs. Staff received training and were supported in their role by regular one to one meetings and team meetings to discuss their work and matters relevant to the service. Annual appraisals allowed staff to reflect on their achievements and plan their future development needs.

Staff gained people’s consent before providing support and care. People’s right to make decisions was protected and when necessary decisions were made in their best interests.

People were supported to stay healthy. Healthcare advice was sought and followed through appropriately. Regular reviews of people’s health and wellbeing were undertaken.

People were supported to eat and drink. A variety of nutritional food was available in sufficient quantities to maintain a balanced diet. People were supported in their choice of food and drink and when necessary their nutritional intake was monitored.

People were treated with kindness, dignity and respect. They and their relatives were involved in planning and reviewing decisions about their care. Staff were kept up to date with information related to the changing needs of people they supported.

There were positive interactions between people and staff. Humour as well as compassion was seen throughout the inspection in the dialogue and relationships observed.

People were supported in a variety of activities that were available for people to take part in. These were based on their personal preferences and needs.

Feedback was invited to help assess the quality of the service and assist in its development. A complaints procedure was available but no complaints had been received since the previous inspection.

We found an open culture in the service. People, staff and relatives thought the service was well-led and managed. Staff were comfortable to approach the registered manager or practice manager for advice and guidance. They felt they all worked together as a team for the benefit of the people they supported.

The quality of the service was monitored by the registered manager and provider through a system of audits and reviews.

As part of this inspection we spoke with the one person who uses the service, three relatives of people who use the service, the registered manager, two care staff and the local authority. We also reviewed records relating to the management of the home which included, three care plans, daily care records, risk assessments, audits, policies and procedures.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

People had been cared for in an environment that was safe. They were supported by staff who understood safeguarding procedures and were aware of the Mental Capacity Act and Deprivation of Liberties.

Where people's health needs had altered we saw the provider had sought advice from relevant professionals to maintain their wellbeing and safety. Two relatives we spoke with told us staff were aware of the individual needs of people using the service. However, one relative told us they felt their relative who lived in the home was allowed to make decisions which they considered were unwise and consequently could put them at risk.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We spoke with the manager with regard to the Supreme Court ruling which widened and clarified the definition of deprivation of liberty. They were aware of the ruling and had been in contact with the local authority deprivation of liberty safeguards (DoLSs) team and were awaiting further advice. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People had an individual care plan which set out their care needs and also had access to a range of health care professionals. For example: psychologist, speech and language therapist and dietician. People were escorted to and supported throughout healthcare appointments as appropriate. One relative described how support had been provided effectively to increase a person's social inclusion through the use of a communication aid.

People told us that they were happy with the care they received and felt their needs had been met. One person told us. "They help me'. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. We saw activities were planned to achieve positive outcomes for people

Is the service caring?

People said they were supported by kind and attentive staff. Our observations confirmed this and we saw people being spoken to politely and with respect. Staff were patient and encouraging when supporting people in everyday tasks and activities. One relative spoke about: 'warmth' and 'friendliness' of staff and the support provided for their relative to join in activities they enjoy. Then commented: 'it is a tremendous example of a real home.' Another said: 'staff are kind and well meaning." They went on to say it is their relative's home and they were always happy to go back.

Is the service responsive?

People's needs had been assessed before they moved into the home and were reviewed with them and their relatives as appropriate. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Staff told us they felt supported by management and could approach the manager for advice. They knew their responsibilities and the importance of their role. They said they had been consulted before the move to the new address and their views had been taken into consideration.

Relatives of people who use the service said they were consulted about their views at review meetings or through conversations with the manager. Most relatives said they felt they had been listened to and as a result changes had been made. For example: bathroom equipment had been altered. One relative told us the manager was 'professional' and 'leads (the team) well.'