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Inspection report

Date of Inspection: 11 September 2013
Date of Publication: 1 April 2014
Inspection Report published 01 April 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 11 September 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

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 with us.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare.

Reasons for our judgement

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We spoke with one relative who was visiting the home on the day of the inspection visit. They told us “They understand (my relative) and are aware of how their ways make it difficult to care for them at times. They are all very patient and understanding.” They also told us “They are quick to get a GP when this is needed and always notice if their health changes.”

We spoke with a visiting mental health professional. They told us “They are doing a fantastic job with all our patients. The rapport with staff is brilliant. They are quick to contact me if there is any change in mental health and cooperate well with treatment plans.”

We carried out SOFI observations during the inspection visit. We saw one person being assisted to walk. Staff spoke with this person to reassure them and to explain what was happening. They waited for the person to respond when they asked a question and carried out the move in a patient way. Another person was assisted to join in with an activity. Staff were encouraging and the person clearly appreciated the positive comments.

We noted that when staff assisted people to eat and drink, they did so from a seated position so that they were able to focus their attention and speak with the person easily. When staff engaged in activities with people they gave their full attention. Staff spent time with all the people in the room, including those who were withdrawn or quiet. This meant that people who were unable to express themselves clearly received the same care and attention as those who could. People were treated with kindness, compassion and were treated as individuals.

Staff told us they had received training in dementia awareness. They had been given specific information about each individual person they cared for so that they could understand how dementia and other conditions had an impact on their needs. They had read personal histories which had been completed by families to help them understand people’s personalities and interests. We saw written evidence that staff had received dementia awareness training so that they could offer the most appropriate support to people.

Assessments and care plans included information about both physical and mental health. They gave staff valuable information about the person, their likes and dislikes, their personality and what was important to them including interests and significant relationships. Staff told us they read care plans and were involved in writing daily notes and making sure the information in care plans was kept up to date. They told us the information in care plans helped them to give focused and personalised care. We saw that daily notes contained information to allow staff to offer people appropriate care.

When we examined care plan records these were on a Standex system. This was prescriptive in the way it required assessed needs to be recorded. We discussed with senior staff the way in which mental capacity, deprivation of liberty safeguards and nutritional needs were recorded (including the use of the Malnutrition Universal Screening Tool (MUST)). It was clear that staff were not always sure how to complete these sections accurately. We discussed the difference between an overall assessment of mental capacity and an assessment of capacity about a particular decision which would need to be made by a multidisciplinary team under best interests protocol. The Standex system led staff to record a general assessment of mental capacity as though it were a best interests decision and it was therefore confusing. The MUST tool had not always been filled in accurately and staff told us this was because it felt over complicated. The provider may wish to note that care plan records in these areas were sometimes not clear. This could have a negative impact on care.

We observed people engaging in the activities taking place. Staff