A single inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?We spoke with four of the five people who were currently using the service, and three members of staff, including the Registered Manager.
Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Assessments were carried out and reviewed regularly for aspects of health and safety. Individual risk assessments were incorporated into the full support plans, and included, for example, self-neglect, isolation, accessing the community and absconding.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff were trained to understand when an application should be made, and how to submit one.
We checked a sample of records to show that the premises were maintained safely. Fire evacuation drills took place regularly so that staff and people using the service had practice in leaving the premises safely in case of fire. Staff carried out a weekly check of the premises to ensure that people using the service, staff and visitors were safe.
Is the service effective?
Sufficient staff were on duty at all times to meet the needs of the people who used the service. The daily rotas recorded any support that people needed, for example to attend recreational activities or medical appointments in the community, and allocated a specific member of staff to provide that support.
The care plans provided clear information on each person's physical and mental health care needs. Guidance on each person's mental health needs included the support they needed if their behaviour changed and contacts with psychiatrists and the community mental health team. One person told us that they were due to have a Community Psychiatric Assessment (CPA) meeting the following week and they looked forward to discussing a change of medicine with their consultant psychiatrist. They said, “I need less (specific medicine) here because I feel better about myself.” Another person said, “A happy environment affects your mental health.”
People were provided with a choice of suitable and nutritious food and drink. The provider allocated a weekly budget to each person who used the service to buy their own food. People chose the food that they wanted to eat, and their support workers assisted them to prepare it according to their abilities. One person told us that they were able to go to the nearby shops by themselves to buy food for their meals. They said, “Because we live right by the shop I can eat more healthy.”
Is the service caring?
One person said, “The carers are nice, there is always someone to talk to.”
Assessments and support plans were written and reviewed by each person together with their key worker. Each person completed “All About Me”, which gave their views of their care and treatment and their likes and dislikes. One person wrote, “I like to be in control of my life. I like my voice to be heard and my opinions to be respected as I know myself better than anyone else.” All About Me for another person included their desired outcomes for their stay at the service, and the support that they wished from the staff.
Is the service responsive?
People who used the service were asked for their views about their care and treatment and they were acted on. Each person who used the service had regular meetings with their key worker when they reviewed their support plan and goals, and made suggestions for any changes they thought were needed. There were monthly house meetings where people using the service met with staff to discuss management of the house and activities, and to comment on what the service was doing well and what they could do better.
Is the service well-led?
The Registered Manager supported and encouraged staff to understand the ethos of the home and to improve the quality of the services they provided. The Registered Manager was also manager for two other Care Assist services in the locality. Staff we spoke with said that she provided them with good support and they were clear about their roles and responsibilities.
The provider had an effective system to regularly assess and monitor the quality of service that people receive. They carried out quarterly quality audits of all the home's records and procedures and six monthly satisfaction surveys of people using their services and their families. The report of the last survey in January 2014 showed that 97% of people using Care Assist services were very positive.