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Inspection Summary


Overall summary & rating

Good

Updated 16 December 2015

The inspection was carried out on 24 and 26 August 2015 by two inspectors and an expert by experience. It was an unannounced inspection. The service provides personal care and accommodation for a maximum of 38 older people. The service has 32 single bedrooms and usually only accommodates 32 people unless couples request shared accommodation. There were 32 people living at the service at the time of our inspection. People had varied communication needs and abilities. Most of the people were able to talk with us about their experiences.

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.

The registered manager was supported by a deputy manager and a team of senior carers to ensure the daily management of the service.

People lived in a clean and well maintained environment. Staff had a thorough understanding of infection control practice that followed the Department of Health guidelines, which helped minimise risk from infection. The premises had not been designed to meet the needs of people living with dementia. We have made a recommendation about this.

Staff training was up to date and was renewed annually, and staff had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular supervision sessions and were scheduled for an annual appraisal to ensure they were supporting people based on their needs. Some staff in housekeeping and catering roles had not completed training appropriate to their roles. We have made a recommendation about this.

Staff communicated effectively with people and responded to their needs promptly. Staff treated people with kindness and respect, some language used by staff did not reflect the values of the service. We have made a recommendation about this. We observed frequent friendly engagement between people and staff and staff responded positively and warmly to people. People were satisfied with how their care and treatment was delivered.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how risks of re-occurrence could be reduced.

There were sufficient staff on duty to meet people’s needs. Staff had time to spend supporting people in a meaningful way that respected individual needs. Staffing levels were calculated according to people’s needs and were flexible to respond to changes in need.

There were safe recruitment procedures in place. These included the checking of references and carrying out disclosure and barring service checks for prospective employees before they started work. All staff were subject to a probation period and disciplinary procedures if they did not meet the required standards of practice

Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed before they moved into the service and were continually reviewed. This ensured that the staff knew about their particular needs and wishes when they moved in.

The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS). All care staff and management were trained in the principles of the MCA and the DoLS and were knowledgeable about the requirements of the legislation.

The building was warm and welcoming. People lived in a clean environment. People’s own rooms were personalised to reflect their individual tastes and personalities.

The service provided meals, in sufficient quantity that were nutritious and well balanced. People were offered hot drinks and snacks throughout the day. Staff knew about people’s dietary preferences and restrictions.

People were involved in their day to day care. People’s care plans were reviewed with their participation or their representatives’ involvement.

Clear information about the service, the management, the facilities, and how to complain was provided to people and visitors. A brochure and service user guide were available and menus and information regarding activities were displayed.

People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.

People’s individual assessments and care plans were reviewed twice a year with their participation or their representatives’ involvement. People’s care plans were updated when their needs changed to make sure they received the care and support they needed.

A range of activities was provided. Information about people’s hobbies, interests and skills was not always used to plan how they were supported to spend their time. We have made a recommendation about this.

The service took account of people’s complaints, comments and suggestions. People’s views were sought and acted upon. People’s relatives were asked about their views when they visited the home and when people’s care plans were reviewed. The service sent annual questionnaires to people’s relatives or representatives and analysed and sought to act upon the results of the surveys.

The service notified the Care Quality Commission of any significant events that affected people or the service and promoted a good relationship with stakeholders.

The registered manager kept up to date with any changes in legislation that may affect the service, and participated in monthly forums with other managers from other services where good practice was discussed. The registered manager and deputy manager carried out comprehensive audits to identify how the service could improve. They acted on the results of these audits and made necessary changes to improve the quality of the service and care.

Inspection areas

Safe

Good

Updated 16 December 2015

The service was safe.

Staff were trained to protect people from abuse and harm and knew how to refer to the local authority if they had any concerns.

Risk assessments were centred on the needs of the individuals and there were sufficient staff on duty to safely meet people’s needs.

Safe recruitment procedures were followed in practice. Medicines were administered safely.

The environment was secure, well maintained and cleaned to a good standard.

Effective

Good

Updated 16 December 2015

The service was effective.

The registered manager had ensured the requirements of the Mental Capacity Act 2005 were met in respect of people making decisions about their care.

Staff in care roles were trained and had a good knowledge of each person and of how to meet their specific support needs. However, some staff in housekeeping and catering roles had not received the training they required to work safely.

The registered manager had ensured that relevant applications to the statutory authority in relation to Deprivation of Liberty Safeguards office had been submitted.

People were supported to be able to eat and drink sufficient amounts to meet their needs and were provided with a choice of suitable and nutritious food and drink. People were referred to healthcare professionals promptly when needed.

Caring

Good

Updated 16 December 2015

The service was caring.

Staff communicated effectively with people and treated them with kindness and compassion, but some language used by staff did not reflect the values of the service.

Staff promoted people’s independence and encouraged them to do as much for themselves as they were able to.

People’s privacy and dignity was respected by staff.

Responsive

Good

Updated 16 December 2015

The service was responsive.

People’s care was personalised to reflect their wishes and what was important to them. Care plans and risk assessments were reviewed and updated when needs changed. The delivery of care was in line with people’s care plans.

The service sought feedback from people and their representatives about the overall quality of the service. Complaints were addressed promptly and appropriately.

Well-led

Good

Updated 16 December 2015

The service was well led.

There was an open and positive culture which focussed on people. The manager operated an ‘open door ‘policy, welcoming people and staff’s suggestions for improvement.

There was an effective system of quality assurance in place. The registered manager carried out audits and analysed them to identify where improvements could be made.