Background to this inspection
Updated
3 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 1 December 2016 and was unannounced. The inspection team consisted of an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed the information we held about the home. This included any incidents the provider was required to tell us about by law and concerns that had been raised with us by the public or health professionals who visited the service. We also reviewed information sent to us by the local authority who commission care for some people living at the home.
During the inspection we spoke with nine people who lived at the service, three visitors to the service and spent time observing care. We spoke with two care workers, the activity coordinator and the registered manager. Following the inspection we contact the community nurses to get their views on the care people receive.
We looked at four care plans and other records which recorded the care people received. In addition, we examined records relating to how the service was run including staffing, training and quality assurance.
Updated
3 February 2017
The inspection took place on 1 December 2016 and was unannounced.
The home is located in Spalding in Lincolnshire and provides residential care for up to 28 older people and people living with a dementia. The accommodation is all one level and there are several communal areas where people can choose to spend their time.
There was a registered manager for the home. 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.
The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. The registered manager had fully understood their responsibilities under the MCA and DOLS and had taken appropriate action to protect people’s rights. In addition the environment and care provided allowed people to maximise their decision making abilities.
People received high quality care from a staff team which were supported to develop their skills through ongoing training, supervisions and observations by the registered manager. Flexible staffing levels set to meet people’s needs ensured that staff had the time to deliver person centred care and monitor changes in people’s needs. Any changes in needs were discussed with the appropriate healthcare professionals and corresponding changes in care were reflected in people’s care plans. This personalised care supported people to stay healthy and maximise their independence and ability to make decisions.
People were supported to lead fulfilling lives and to continue with hobbies they enjoyed before moving into the home. Activities were provided in the home on a communal and an individual basis and people were also supported to access the local community.
The registered manager and staff provided high quality compassionate care to people at the end of their lives. Extra staff ensured that people received one to one support through their final days. Good collaborative working with external healthcare organisations ensured that people were able to be kept comfortable and pain free at the end of their lives.
Risks to people were fully identified. Care was planned to minimise the risk to people and equipment was available when needed. Good adherence to the care plans and the correct use of equipment had led to a decrease in the amount of pressure ulcers developed in the home.
Caring staff ensured that people took their medicine as prescribed and raised concerns around medicines with appropriate healthcare professionals. People’s food was presented to them personalised to their individual preferences. People received gentle support and encouragement at mealtimes to maximise their nutritional intake. This supported people to maintain their independence and decreased the risks associate with poor mobility and fragile skin.
The registered manager had effective audits in place to monitor the quality of care that people received and they were able to address identified issues in an appropriate and timely way. They continually updated themselves on guidelines developed by the government and NHS to ensure that the care provided supported people to lead healthy fulfilled lives.