Background to this inspection
Updated
24 March 2016
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 6 and 7 January 2016 and was unannounced. The visit was undertaken by one inspector and an expert by experience on the first day and one inspector on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
As part of the inspection we looked at the information we had about this provider. We also contacted service commissioners (who purchase care and support from this service on behalf of people who live in this home) to obtain their views.
The provider was asked to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was received when we requested it.
Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any safeguarding matters. Appropriate notifications had been sent by the registered provider.
All this information was used to plan what areas we were going to focus on during the inspection.
During the inspection we met and spoke with six of the people who lived in the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us. We also spent time observing day to day life and the support people were offered. We spoke with five relatives of people and two visiting health and social care professionals during the inspection to get their views. In addition we spoke at length with three care staff, one senior care staff, the chef, the deputy manager, the registered manager and the proprietor.
We sampled four people’s care plans and medication administration records to see if people were receiving the care they needed. We sampled three staff files including the recruitment process. We looked at some of the registered providers quality assurance and audit records to see how they monitored the quality of the service.
Updated
24 March 2016
We inspected this home on 6 and 7 January 2016. This was an unannounced Inspection. The home was registered to provide residential care and accommodation for up to 19 older people. At the time of our inspection 18 people were living at the home.
The registered manager was present during our inspection. 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.
People using this service told us they felt safe. Staff understood their roles and responsibilities to protect people from the risk of potential harm. Risks had been assessed to keep people safe and protected, whilst not compromising their freedom and choices.
People and their relatives made a number of positive comments about the staffing arrangements in the home and their confidence in staff. Pre-employment checks were carried out to ensure staff were suitable to work in the home. Safer recruitment checks were needed in relation to obtaining references.
People received their medicines as prescribed; however, the management of some medication needed to be improved for medication not taken on a regular basis. Potential for errors were noted in respect of medication administration where medicines were not needed routinely or were not in a monitored dosage system.
People were supported by staff who had the skills, experience and knowledge to meet people’s individual needs. Staff told us they were well supported and received supervision regularly.
Staff we spoke with had received training in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). However, they were unsure about how to apply the principles of the MCA into their practice. Necessary applications to apply for Deprivation of Liberty Safeguards (DoLS) to protect the rights of people had been submitted to the local supervisory body for authorisation.
People’s nutritional and hydration needs had been assessed and people were supported to eat and drink sufficient amounts to maintain good health. People were supported to access a wide range of health care professionals.
People told us that staff were kind and caring. We saw instances when people’s privacy and dignity were compromised.
People told us they were involved in the initial planning of their care and that they were happy with their care. People were not always involved or contributed to the reviewing of their individual needs.
People told us some activities of particular interest to them were provided for them to participate in. However the activities offered on occasions were not engaging enough for all people in the home. .
Procedures were in place to support people and their relatives to raise any complaints. Plans were in place to ensure that and informal concerns raised would be recorded and utilised to improve the service.
People, their relative’s and staff consistently told us that the registered manager was kind, approachable and supportive.
Quality assurance systems in place were ineffective to monitor and quality assure the service people received. The systems did not ensure the home was consistently well-led and compliant with regulations.