We visited Stockwell Grange on 4 April 2012 to carry out a follow up inspection to check improvements the home had made after our review of compliance in July 2011. We looked at the information we had about the service before we visited. We spoke to three people that used the service, two visiting relatives, four staff and the acting manager. We also looked at three people's care records and other records associated with the operation of the service.
People's views and experiences were verbally taken into account in the way the service was provided and delivered in relation to their care.
People and their relatives told us that the care provided was as they wished and their needs were met. People decided what they wanted to do where possible and staff supported them with these decisions. We heard staff promoted people's privacy and dignity with people saying they put them at ease when caring out intimate care.
We saw from observation that staff did encourage people to be as independent as possible and we heard that people were allowed to take an active part in their own care when they could.
The provider should note that the care records we looked at had not always confirmed the involvement that people and their representatives told us they had in planning their care.
People who use 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.
We spoke with people and their relatives and they felt that people were safe at the home. One person told us that they 'feel quite safe'. People and their relatives said they would be confident raising concerns with staff.
We spoke with the acting manager about their understanding of what they should do if they identified any abuse and they showed a good understanding of the actions they should take to protect people.
We also spoke to staff and they recognised what would constitute abuse. They also knew that they needed to report any abuse to the manager, or where appropriate 'whistle blow' to statutory agencies.
We spoke with staff as to their understanding of the Mental Capacity Act and the implications this may have for their practice. They acknowledged they would benefit from better awareness of what this meant for their work. People and their relatives told us they were given choices even if they may not always have capacity.
Appropriate checks were not undertaken on volunteers that work at the home.
We saw that a relative was working at the home on a voluntary basis to attend to people's hair. We saw that staff were able to see this person whilst they were working with people, and the relative was well known to people who lived at the home. We were told by the acting manager that there had been no criminal records bureau check (CRB) carried out. We saw that risks to people were minimised as the individual was not working on an unsupervised basis but the provider should note that a risk assessment must be completed until the CRB check is received.
We spoke to people and some visiting relatives and they told us that the staff provided them with a good standard of care.
Staff told us they worked well together but identified areas of training that they thought they needed to help them do their jobs better. The manager had identified some of these and had put some staff forward for training.
Staff did express some concerns about staffing levels with this impacting on the time that they had to spend on social activities with people. The changes to ancillary staffing had also caused some discontent as staff felt they were having to do more domestic tasks as opposed to care. Overall staff felt they needed more support, this something the manager was preparing to address following their recent appointment to their position.
People who use the service; their representatives and staff were asked for their views about their care and treatment and they were acted upon.
People and visiting relatives we spoke with told us they were fully satisfied with the support they received from the staff and they were happy and settled. Visitors expressed their satisfaction and said they could speak with the manager if they had any concerns or worries.
Staff told us that they were not always confident in sharing issues, this partly as there was a new manager and they didn't all feel that there had been sufficient time to build professional relationships in the short time they had managed the home. The acting manager told us that they were aware that this was an issue and was one of the areas that they hope to improve upon.
Discussion with the acting manager did show that they had an understanding of where the service needed to develop and the high level of satisfaction that we heard people have with showed us that they felt good quality care was provided.