7 July 2016
During a routine inspection
At the time of the inspection, the service was proving support to seven adults and seven children.
A registered manager was in post. 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.
We looked at how medicines were managed within the service and found that medicines were not always accurately recorded. People we spoke with told us that they received their medicines when they needed them.
People receiving support, their representatives and staff we spoke with, told us people received support from the service that maintained their safety. Staff were knowledgeable about safeguarding and how to report concerns and we found that appropriate referrals had been made.
Processes were in place to assess risks to people in order to maintain their health and wellbeing, including personal emergency evacuation plans (PEEPs). Risks relating to staff had also been assessed to help ensure their safety whilst at work.
There was an accident policy in place and accidents and incidents were recorded and reported appropriately.
We looked at how the service was staffed and found that there were sufficient staff employed to meet people’s needs. We found that effective recruitment procedures were in place and followed to help ensure staff were suitable to work with vulnerable people.
We looked to see if the service was working within the legal framework of the 2005 Mental Capacity Act (MCA). People told us staff sought their consent, though records did not always reflect that people had provided consent to their care and treatment. Mental capacity assessments were completed if there were concerns regarding people’s capacity.
We found that staff were supported in their role through induction, training, supervision and appraisals. Staff felt well supported and able to raise any concerns.
People were supported by staff and other health care professionals to maintain their health and wellbeing. Staff supported people to maintain their nutritional wellbeing when necessary, by assisting with food preparation and providing support to eat and drink.
People told us staff were kind and caring and treated them with respect. Staff told us how they maintained people’s dignity and spoke about people in a warm and caring manner.
Staff we spoke with had a good understanding of people’s needs and preferences. Care files provided information about people’s needs to help ensure staff were able to meet them.
Care plans were written in such a way to promote people’s independence and most care plans reflected that people had been involved in their creation.
The registered manager told us that staff regularly advocate for people, such as contacting relevant people to obtain equipment or services they would benefit from.
People we spoke with told us they had been involved in the development of their care plans and were happy with the support in place. All care plans we viewed had been reviewed regularly and people we spoke with told us they were involved in these reviews.
Staff told us there were processes in place to ensure they were informed of any changes in people’s care needs. This meant that people were supported by staff that were knowledgeable about their needs.
Most care plans were specific to the individual person, detailed and informative.
Not all risks identified in people’s risk assessments, had care plans to show how those risks would be managed.
Care files included information regarding people’s general medical conditions which helped to ensure that they were supported by staff who had an understanding of their physical conditions.
Staff supported people to access social and leisure activities they were interested in.
There were processes in place to gather feedback from people and listen to their views, such as quality assurance surveys.
There was a complaints procedure available in the office; however this was not usually provided to people using the service. People we spoke with all told us that they would contact the office if they had any concerns and felt comfortable to do so.
The service had a registered manager in post and people told us that the service was well run.
Staff were aware of the companies whistle blowing policy and told us they would not hesitate to raise any issue they had.
Systems were in place to help ensure that the provider had oversight of the running of the service and to ensure the quality and safety of the service though not all concerns were identified.
The manager had not notified CQC of events and incidents that occurred in the service in accordance with our statutory notifications.