Archived: H C S (Enfield) Limited - 221 Holtwhites Hill

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on discussions with management during the inspection, speaking with relatives of people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

In general safeguarding procedures were robust and staff received appropriate training and information. Staff understood their responsibilities in safeguarding the people they supported and who to contact in the event of a concern.

Staff were familiar with people's risk assessments and how to manage and mitigate those risks.

Relatives of people using the service felt that their family members were cared for safely.

People were treated with respect and dignity by the staff. People were supported to express their views and concerns using different methods of communication which were appropriate for each person.

Systems were in place to make sure that accidents and incidents were reported along with complaints and other concerns and action taken when required. This reduced risks to people and helped the service to continually improve its performance.

There were procedures for managing emergencies. Staff had appropriate training and were aware of relevant procedures and contacts to access help and support.

Recruitment practice was safe and thorough in some areas and ensured that suitable checks were in place with regard to qualifications, employment history, identity and criminal records. However, health declarations were not seen for all staff. There was suitable induction training for new staff and on-going supervision checks to ensure that staff carried out their duties safely.

Is the service effective?

People using the service experienced care that was planned and delivered to meet their needs and mitigate any risks. People using the service and their relatives were involved in the development of their care plans which were personalised and took account of preferences, cultural and religious requirements.

Care needs were reviewed on a regular basis and care plans could be modified if needs changed. Records showed that the care delivered reflected the current care plan but reviews were not always fully documented or up to date. Monthly reports supplemented reviews to help ensure that care and support was in line with current needs. People were encouraged to engage in activities and life inside and outside the home and to be involved in managing their care as far as possible.

Is the service caring?

We observed that people were cared for by kind and sympathetic staff. Staff we spoke with were aware of the importance of understanding individual preferences and routines and using ways to communicate with people that were unable to express themselves verbally.

Relatives of people we spoke with told us they were happy with the care and support provided and that staff were kind and supportive in meeting their needs.

One family member said, 'The staff are very good. They're always friendly and helpful and she's always happy and smiling', while another relative commented, 'They're wonderful ' she's very well looked after.'

Is the service responsive?

People using the service received an annual satisfaction survey in which they were asked to rate the quality of the service they received. The latest results indicated a high level of satisfaction with the service.

Monthly meetings were held with people and reports were produced by staff for each person so that any concerns could be addressed promptly and changes made to the care and support provided if required.

There was a written complaints procedure which was readily available for people using the service and in a format that was accessible to people and their relatives. Two complaints had been recorded and had been investigated and managed correctly.

Is the service well-led?

The provider had a variety of systems to monitor the quality of service provided and audit their performance.

People using the service and their relatives were provided with information about the service and were contacted regularly to obtain their feedback and views.

There were appropriate procedures for dealing with complaints and reporting accidents and incidents.

Staff had regular meetings at which they could discuss their case load and any issues or concerns. Staff had regular training and supervision to ensure that their skills were up to date and appropriate. This helped to ensure that people received a good quality service.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Staff we spoke with understood the importance of obtaining the consent of the person before any care or treatment took place.

Relatives we spoke with were positive about the care and treatment provided at the home. One relative commented 'we turn up at odd times and the home always seems clean and the people well looked after.' We saw that the way staff were interacting with people had a positive effect on their well being.

All medication records we saw were accurate and showed us that medication was being managed appropriately.

Relatives were positive about the staff team and their comments included 'he is very happy with the staff,' 'they are very good' and 'they are like my family.'

We saw that people's complaints were fully investigated and resolved, where possible, to their satisfaction.