5 and 6 October 2015
During a routine inspection
At our last inspection in February 2015 we had concerns about the care and welfare of people, staffing, records and quality monitoring. There were breaches of regulations. We asked the provider to take action. Following the inspection the provider sent us an action plan. They told us they would meet the relevant legal requirements by July 2015.
At this inspection we found some improvements had been made. However further improvements were needed to some people’s care plans to ensure they had detailed personalised information. Some did not provide sufficient detail about people’s likes, dislikes and preferences. This meant there were inconsistencies and some people did not receive person centred care. The registered manager told us the service was in the process of changing the documentation and the process for ensuring information was updated.
During our inspection we saw evidence that people and their relatives were being involved in a review of their care plan and their choices and preferences were being updated. However this process had started in October 2015 and was on-going at the time of our visit. This meant at the time of our inspection some people did not have a personalised care plan however there was a plan to address this.
Some improvements had been made to quality monitoring systems. However further improvements were needed to ensure all care records were checked and any gaps identified, to consistently ensure people received person centred care. People’s care records included some observation charts which were kept in people’s own rooms. They were a record of the checks people needed or if necessary a record of the food and drink they had received. They also included a repositioning chart, for people identified as at risk of skin damage. There was a twice daily check of observation charts by a registered nurse who signed to confirm the checks had been completed. Discrepancies were identified promptly and corrected.
Regular review of people’s risk assessments and risk management plans were completed. People who needed regular checks or observations had them recorded as needed.
The provider was actively recruiting staff. The registered manager told us they were recruiting more staff than required in order to ensure there was always sufficient staff to cover staff absence. Staff told us staffing had improved and they felt there were sufficient numbers on duty. One health and social care professional told us they had visited the home at different times and there were enough staff to meet people’s needs.
Staff told us the registered manager was approachable and supportive and that morale in the home was good. Staff spoke warmly about people and each other. Some staff and people described the home as “like a family.” Staff told us they loved working in the home.
Staff told us training had improved and there were more opportunities for learning.
People had access to healthcare and staff responded to people when they showed signs of being unwell. Health and social care professionals told us that staff refer people appropriately and follow recommendations.
People were able to engage in a range of activities which were provided in either a group or individual basis.