18 June 2014
During a routine inspection
Below is a summary of what we found. The summary is based on our observations during the inspection, from looking at records and from speaking with six people using the service. We also spoke with the new home manager, the activities co-ordinater and care staff on duty.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
We asked people using the service if they felt safe at the home. People told us that they did. One person said, 'I know I'm being looked after safely.' Another person told us, 'This is a much better environment than my flat. It was dangerous on my own.' And another said, 'I feel very safe here.'
Any potential risks to people's health, safety and welfare within the home were assessed by senior staff. There was appropriate guidance for staff on how to take action to minimise these risks to keep people safe from harm or injury in the home. This information was checked regularly by staff which meant they had up to date information about how to keep people safe.
People were cared for in an environment that was kept clean and hygienic. Staff knew how to maintain good standards of cleanliness and hygiene within the home to reduce the risk of cross infection, as they had received appropriate training to do so.
The provider had carried out appropriate checks on the majority of staff before they started work at the service. This included carrying out security checks to ensure people were not barred from working with vulnerable adults. We did however find one example where all the appropriate checks had not been made before the staff member commenced work. We have reminded the provider about their obligation to ensure these checks are carried out for all members of staff to assure themselves people are suitable and eligible to work in the home.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required.
Is the service effective?
People's specific needs had been taken into account when staff planned their care and support. People's records showed these were reviewed regularly by staff to identify any changes that were needed in the care or support provided. There was information and guidance for staff on how to provide appropriate care and support that met people's needs. Staff we spoke with demonstrated a good understanding and awareness of the people they cared for and in particular, what was important to them.
The service worked proactively with other healthcare providers to ensure people in receipt of intermediate care were supported to achieve their goals and ambitions. People we spoke with told us they were able to track their progress in achieving their goals and spoke positively about the support staff gave them to assist them in this.
Is the service caring?
People we spoke with had positive experiences of staff that worked in the home. Comments we received included; 'Staff are very friendly and very caring'; 'It's very good here. They're 100 per cent caring.'; 'I'm quite happy here. It's homely and they're all friendly here'; 'I'm fine. I've got nothing to complain about. 'And, 'They're all lovely here.'
During our inspection we observed warm, friendly and kind interaction between staff and people using the service. Staff spoke with people respectfully and took time to listen and chat with them. People that needed extra help and support moving around the home or with eating and drinking were not rush or hurried by staff and could do so at their own pace.
Is the service responsive?
There were appropriate mechanisms in place to monitor people's general health and wellbeing. We saw regular checks were made and documented and staff used this information to highlight and take appropriate action about underlying issues or concerns they had about an individual's health or wellbeing. This information was shared so that all staff had the most up to date information about people's current care and support needs.
When people made complaints about the service we saw senior staff took appropriate action to investigate and resolve these to people's satisfaction. However the service needed to ensure guidance for people about how to complain, was up to date and contained relevant information.
From our conversations with the home's manager and staff we were made aware of their concerns about recent referrals made to the home from external professionals which may have not been appropriate. The manager confirmed they had raised their concerns with the local Clinical Commissioning Group. There were no specific concerns or issues about anyone currently using the service. However, we have asked the provider to be aware of possible risks to people placed at the home inappropriately.
Is the service well-led?
The provider took appropriate steps to ensure changes within the service were well managed and caused minimal disruption to people using the service. At the time of our inspection we were aware that the registered manager, who's name appears in this report, had recently left the service to take up a new role. An application to remove their registration has been received. The home's deputy manager had been appointed as the new home manager and had submitted a registered manager application to CQC. People using the service and staff spoke positively about this appointment. One person said, 'The manager is such a nice chap and you couldn't meet a nicer man.'
The views and experiences of people using the service and their relatives were sought by the service. Changes and improvements to the service were made when people wanted or needed these.
The provider understood the importance of robust quality assurance and carried out regular checks to assess and monitor the quality of service provided.