An inspector for adult social care services carried out this this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?As part of this inspection we spoke with three people who used the service although their complex needs meant they could not tell us verbally what they thought about the service. We observed how people were being supported. We were not able to use a formal observational tool because people were independently mobile around their home. We spoke with the registered manager and two other members of staff.
We reviewed records relating to the management of the service. This included three care plans, daily records, policies and procedures, staff records and the provider's monitoring records.
Below is a summary of what we found. The summary describes what the manager and the staff told us, what we observed and the records we looked at.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People were treated with respect by staff. The duty rosters took into account people's needs and ensured that safe staffing levels were maintained. Risks to people's health and welfare had been assessed and staff understood how they were to minimise these.
Systems were in place to ensure that the manager learnt from incidents and concerns and took action to reduce any risks as well as improving the service. Systems also ensured that the service was clean and hygienic and staff were clear about how to minimise the risk of any infection spreading. Standards of cleanliness were checked to ensure people's safety was promoted. We noted that other checks were made on the safety of the home and the management of medicines so that people were protected from avoidable risk.
The home had procedures in place in relation to the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) and staff had training in this. We noted that information was displayed on the office wall so that the manager had easy access to guidance and telephone numbers to seek advice if this was required.
Is the service effective?
People's health and care needs had been assessed and used to develop plans of care reflecting how each person was to be supported. Advice from health professionals had been included in care plans to ensure people's needs were met, including for support with eating and drinking or communicating. Staff were able to tell us about people's needs. This meant that staff knew how to support people properly.
Staff had relevant training so that they knew what was expected of them and had knowledge to support people effectively. However, they were not appropriately supported by means of supervision and appraisal to carry out their work. We have asked the provider to tell us what they are going to do to meet the requirement to support staff in their work.
Is the service caring?
We observed that people were supported by kind and attentive staff. We saw that staff gave encouragement to people, that people showed no signs of being ill at ease around staff and smiled at staff who were on duty. Arrangements had been made for people to join in celebrating someone's birthday and go out for the evening.
Staff told us they were confident that people were treated with respect. They knew how people showed whether they were content, distressed or becoming unwell so that they could provide support people needed.
Is the service responsive?
We saw that people engaged in activities inside and out of the home. Our discussions with staff and the manager showed that the staff team were looking to increase the opportunities people had to go out, particularly at weekends and to find activities that people would enjoy.
We noted that if there were concerns that someone was becoming unwell these were followed up promptly so they could get advice or treatment. Assessments of risk were reviewed regularly and plans of care were updated if people's needs changed.
Is the service well-led?
The manager ensured that the quality of the service was monitored regularly. Although there was no formal survey process, people and their representatives were involved in reviews so that they could comment on standards of care. Staff said they could raise suggestions for improvement.