8 May 2014
During a routine inspection
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with 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 our full report.
Is the service safe?
Overall, our findings showed that people's needs were assessed, and care and support was planned and delivered in line with their individual needs. However, some people were being placed at risk due to a lack of documentation to support changes in their circumstances or specific healthcare requirements.
Although people received their prescribed medication at the right time on the day of our inspection, they were being placed at risk of not receiving their medication when they needed it and in a safe way in the future. This was because medication records were not accurate, or were not being completed at the time of administration.
People were cared for in an appropriate environment, but the manager recognised that it was in need of updating and redecoration. He told us he had secured funding to refurbish the whole building. A date for this to happen was not yet known.
People who lived in the home were safe because appropriate checks had been undertaken before staff began work, and their health and welfare needs were being met by sufficient numbers of appropriately skilled staff.
The manager had introduced new systems to monitor the quality of the service provided to people living there, but these were not sufficiently robust. Further improvements were required to ensure all aspects of the regulated activity provided to people living in the home were assessed, and identified concerns or risks managed appropriately.
We also found that some records maintained by the home, were not accurate or fit for purpose. For example, we found handover notes for each person living in the home that had been completed almost two and a half hours before the end of the shift.
We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to risk management, medication, quality monitoring and records.
Is the service effective?
People's health and care needs had been assessed and care plans were in place. Care plans we looked at had been reviewed regularly.
Systems were in place to monitor people's healthcare needs. Records we saw showed that two people identified as being at risk of malnutrition, had gradually gained weight over time and been discharged from the local dietetic service as a result.
Is the service caring?
People we observed looked well-presented and cared for, and staff we spoke with understood their needs well. We observed some friendly and positive interactions between staff and people living in the home.
Staff were patient, caring and genuinely warm towards the people they were supporting. One person living in the home described staff as 'gentle.'
We noted through lunch that staff paid attention to people's needs when eating, to enable them to retain as much independence as possible.
Is the service responsive?
It was clear from our observations that staff knew people well, and they were attentive to their needs throughout. One person was heard coughing several times, and staff responded promptly to ensure their wellbeing.
Is the service well-led?
Staff we spoke with were clear about their roles and responsibilities. They told us they felt well supported by the manager and providers.
Despite new systems being introduced to monitor the quality of service provision, it was clear that not all of the shortfalls found during this inspection had been identified or adequately addressed. The manager told us he was working additional hours because of delays in filling a staff vacancy. He admitted that this was having an impact on the amount of managerial time, which had resulted in some things getting behind.