We carried out a review of the data available to us about Ailwyn Hall on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ailwyn Hall, you can give feedback on this service.
We found the following examples of good practice.
Measures were in place to prevent the potential spread of infection by visitors. The service was following national guidance on visiting in care homes. Relatives had been consulted on visiting arrangements. The service had taken a person centred approach to visiting. They had considered people's individual needs, offered a range of communication methods, and adapted the environment to help facilitate meaningful contact.
Staff reviewed the environment and made changes to support people to socially distance where possible. Not everyone living in the service was able to socially distance. The service had risk assessed this where necessary.
The registered manager had undertaken external training in infection control organised by the local clinical commissioning group. Effective and supportive relationships have been developed with healthcare professionals, this meant the service was well supported in their response to the COVID-19 pandemic.
Ailwyn Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Ailwyn Hall is registered to accommodate up to 39 people. Care is provided over two floors. There are communal areas that people can reside in along with space for dining on the ground floor. At the time of our inspection visit, 18 people were living in the home.
A registered manager worked in the home. 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.
At the last inspection of Ailwyn Hall in February 2018, we rated the home overall as Inadequate. This was because: risks to people’s safety had not been adequately managed; systems to protect people from the risk of abuse were not robust; consent had not been sought from people in line with the relevant legislation; some areas of the premises and equipment people used was unclean; staffing levels were not consistently adequate and staff had not received appropriate training to provide effective care; the governance processes in place were not robust at identifying issues or improving the quality of care provided to people and the provider had not ensured they had notified the Care Quality Commission (CQC) of notifiable events as is required by law. This resulted in six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the CQC registration regulations 2009.
Following that inspection visit, we took urgent action to protect people from the risk of harm. This was in the form of placing a condition on the provider’s registration. This condition prevented them from admitting people into the home and told them they must send us a weekly report detailing how they were managing specific risks to people’s safety. We also placed the home in special measures. Services that are in special measures are kept under review and inspected again within six months from the publication of the report. We expect services to make significant improvements within this timeframe.
The provider had complied with the additional condition we had placed on their registration and at this inspection we found that significant improvements had been made. The provider was no longer in breach of any regulations. The overall rating of the home has changed from Inadequate to Good. Due to this, the home has been taken out of special measures. However, although systems were in place to monitor the quality of care provided to people and any areas for improvement that had been identified had been acted upon, the provider has not consistently met and therefore maintained the required standard of care to ensure that people consistently receive a good level of care. This is why we have rated well-led as requiring further improvement.
Risks to people’s individual safety had been assessed and managed well. Staff had acted to mitigate the risk of people experiencing harm as much as possible.
Systems were in place to reduce the risk of people experiencing abuse. Where incidents or accidents had occurred, these had been thoroughly investigated to try to prevent them from re-occurring.
People received their medicines when they needed them and there were enough staff to keep people safe and to meet their needs. The home was visibly clean as was most of the equipment that people used.
The staff had received appropriate training and supervision to provide people with safe and effective care. The staff were kind, caring and compassionate towards people and treated them with dignity and respect.
People received enough to eat and drink to meet their needs and they were seen by healthcare professionals quickly if they needed to. This was to help them maintain their health.
People were treated as individuals and were involved in making decisions about their own care. Where people lacked capacity to make their own decisions, staff acted in line with the relevant legislation.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staffing levels had been planned to enable staff to spend time with people and to engage them in activities and stimulation to enhance their wellbeing.
The registered manager had instilled an open culture within the home where people were treated as individuals and were valued. The staff were happy working in the home and demonstrated good teamwork and organisation.
The registered manager was keen to continually improve the quality of care people received and had many ideas they were exploring using best practice and guidance.
During our last inspection in May 2017, we found five breaches of Regulations. These had been in respect of Regulations 12, 13, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. This was because risks to people’s safety had not always been managed well or safeguarding incidents reported or investigated appropriately. There was also a lack of staff to meet people’s needs and the provider’s governance systems had not been effective at assessing and monitoring the quality of care people received. Furthermore, the provider had failed to ensure that the Care Quality Commission (CQC) had been notified of certain incidents as is required by law.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe, Effective, Responsive and Well Led to at least Good which was received from them. However, the actions the provider said they would make had not all been implemented.
At this inspection, we found that the provider remained in breach of Regulations 12, 13, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. Furthermore, two new breaches of Regulations 11 and 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to consent and the premises and equipment people used were also found.
We have also made a recommendation regarding the manager and provider familiarising themselves with the Accessible Information Standard. This standard was put in place in 2012 to ensure that people had access to appropriate information to meet their individual communication needs.
Following the first two visits to the home on 5 and 7 February 2018, we wrote to the provider and told them they needed to take urgent action to protect people from the risk of harm. They responded to us and said what they had done to comply with this direction. However, when we revisited them on 13 February 2018 we found that sufficient action had not been taken in all areas to protect people. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.
The overall rating for this service is ‘Inadequate’ and therefore we are placing the service in 'special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
This is the second time that this service has been placed into ‘special measures’. The previous occasion was as a result of an inspection in November 2016. Consequently, we have serious concerns about the provider’s ability to achieve or sustain compliance with the Regulations.
Ailwyn Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 39 people within two units, one called Honingham and the other Mattishall. Most people living in the home are living with dementia from early to advanced stage. At the time of the inspection, there were 34 people living in the home.
There was a manager was working at the home. At the time of the inspection, they were the registered manager at another of the provider’s homes and had applied to CQC to register as the manager of Ailwyn Hall which is currently being assessed. A registered manager is a person who has registered with CQC 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.
The provider had again failed to ensure that robust systems were in place to monitor the quality of care people received. This included the monitoring of staff practice and the safety of some areas of the premises. The manager and provider lacked knowledge in some crucial areas such as safeguarding and health and safety. This had resulted in some people experiencing harm or being exposed to the risk of avoidable harm. Furthermore, people and/or their relatives had not always been consulted about the quality of care they were receiving to help the provider improve the quality of care received. This included not consulting them on a significant change within the home regarding the preparation of their meals.
Risks to people’s safety had not always been assessed or managed well. Incidents that had occurred such as falls or medicine errors had not always been recorded and where they had, had not been investigated in a timely way so they could be prevented or any risks associated with them reduced. This also meant that learning from these incidents could not occur.
Systems in place to reduce the risk of people experiencing abuse were not robust. Appropriate action had not always been taken when actual abuse had taken place or when allegations had been made. This included not reporting these incidents to relevant authorities such as CQC or the Local Authority for their investigation.
The number of staff the provider had deemed as being required to provide people with safe and effective care had regularly not been met meaning there was a risk that people’s needs and preferences would not be adhered to. Furthermore, the staff working on each shift did not always have the relevant training or skills to ensure people’s safety.
Some areas of the home and equipment people used was unclean. Staff were observed on occasions to use poor practice in certain areas which increased the risk of people being exposed to poor care. Some equipment was not always available in a timely way which resulted in staff not being able to be responsive to people’s needs.
Consent had not always been sought from people in line with the relevant legislation. The practice in relation to people being offered choice and being involved in decisions about their care was variable.
Some areas of the premises were well decorated and pleasant but others, such as some people’s rooms, required re-decoration. Safe, independent access was available to some people within the home. However, for others this was more difficult with the only means of leaving one unit independently involving having to negotiate a small step which was a trip hazard and made it more difficult for wheelchair users.
Although we found that some staff were kind and caring and treated people with dignity and respect, this was variable with some people’s dignity and privacy not being respected.
People’s care needs and preferences had been assessed. However, not all care was being delivered to meet these preferences. The care records required more information within them to provide staff with appropriate guidance on how to meet these needs. The manager was aware of this and was actively working to improve this area.
People had access to some activities that complimented their hobbies and interests and enhanced their wellbeing, but again this was variable. The manager was aware of this and was actively working to recruit a new member of staff to the team who could lead and drive improvement within this area.
People received enough to eat and drink to meet their needs and support to maintain their health. Their wishes at the end of their life had been sought and care was provided in line with these at this time. Any complaints or concerns raised were listened to and fully investigated.
Links with the local community had been established for the benefit of people living in the home and visitors such as relatives were encouraged to enhance their own wellbeing. The staff told us they were happy working in the home and felt supported in their work.
Ailwyn Hall provides accommodation and support to a maximum of 39 older people, some of whom were living with dementia. It is not registered to provide nursing care. At the time of our inspection there were 22 people living in the home.
At the time of our inspection visit a registered manager was not 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 last inspected this service on 10 and 14 November 2016 and found widespread and serious issues throughout the service. The provider was in breach of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. As a result of our November 2016 inspection the service had been placed into special measures. We carried out this inspection to check if the improvements had been made in order to achieve compliance with the regulations.
This May 2017 inspection found that improvements had been made. The provider had commissioned an independent consultant to provide support and carry out audits to monitor and identify where improvements were required. A new manager had been appointed to the home in January 2017 and a number of actions had been taken to drive improvements. We found these measures had achieved some success and progress had been made to improve the home which had benefited people living there. Whilst the provider acknowledged there was further work still to be done, they had stopped the decline in the service that our previous inspection had found and had begun to implement positive changes.
As a result of the improvements we found it was determined that the service is no longer in special measures. Given the recent history of the service we will inspect the home again within six months to ascertain whether the improvements made have been sustained and whether progress continues.
This inspection found that there continued to be some concerns with the management of risk to people’s safety and wellbeing. This meant the provider remained in breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found some incidents which had not been appropriately identified as adult safeguarding incidents and had consequently not been reported as required. This meant the provider was in breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The provider had reviewed staffing levels and subsequently increased them. However, we found on some occasions the home was not being staffed to these levels which meant there was not always sufficient staff to meet people’s needs. This meant the provider remained in breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Whilst improvements had been made to the governance in the home, we found further improvements to the quality of audits and monitoring of improvements in the home were needed. This meant that at this inspection the provider remained in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found the provider had not always notified us of events in the home as required. This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and report on what we find. Improvements had been made in this area. The provider had reviewed possible restrictions in place regarding people’s care and made the appropriate applications. Further work was required on assessing people’s ability to consent and make decisions on specific areas of their care.
People did not always receive responsive care as they were not always supported with their personal care needs. Care plans required further improvements as these did not provide sufficient guidance for staff and were not always accurate.
We found improvements had been made to the management of people’s medicines and to staff training in the home. New staff received a formal induction and support to help ensure they understood their role and responsibilities. Staff worked together to support each other to provide effective care.
People received the support they required to eat at meal times. Staff consulted with people and offered them a range of options for their meals. Further work was required to sufficiently monitor people deemed to be at risk of dehydration. Staff contacted health and social care professionals appropriately and when required.
People were supported by kind and caring staff, who were respectful and promoted their independence. There were plenty of activities on offer. Activities were varied and took in to account people’s differing needs and abilities so there was something for everyone.
People, relatives, and staff spoke positively of the changes in the home and the benefits this had brought to both people living and staff working in the home. Staff had confidence in the manager and of their ability to continue to make the improvements required.
Ailwyn Hall provides accommodation and support to a maximum of 39 older people some of whom were living with dementia. It is not registered to provide nursing care. At the time of our inspection there were 30 people living in the home.
At the time of our inspection visit there was registered manager 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 last inspected this service on 10 and 11 May 2016 and found widespread and serious issues throughout the service. The provider was in breach of six regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. We issued a warning notice in respect of regulation 17 which set out the improvements required to systems for leadership and governance. We gave the provider until 16 August 2016 to meet the legal requirements in relation to this warning notice. Following the inspection in May 2016, the provider sent us a plan to tell us about the actions they were going to take to meet the above regulations. They told us they would be compliant by 16 August 2016.
We carried out this inspection to check if the improvements had been made in order to achieve compliance with the regulations and in response to concerns reported to us. At this inspection we found sufficient improvements had not been made. The provider was no longer in breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, we found that few effective measures had been implemented to rectify the breaches found at the previous inspection. The provider was still in breach of regulations for: safe care and treatment, staffing, the need for consent, meeting nutritional and hydration needs, good governance and notifications of serious incidents. We found that in some areas, such as medicines and the management of risk, there had been a further deterioration. This meant that risks to people had increased.
We found people were not being provided with safe care. Risks to people’s health and safety were not always identified. We found in cases where risks had been identified insufficient action had been taken to manage and mitigate the risk of any further harm. The systems in place had also not identified risks to people from the premises.
We found there had been deterioration in the management of medicines in the home. Medicine administration charts were not completed correctly and did not show people had been given their medicines as prescribed. There was a lack of guidance for staff on how to administer medicines. Insufficient action had been taken to manage the risks to people when they refused their medicines.
Although the provider had increased staffing levels, there were still occasions when shifts were not staffed in line with the numbers the provider had identified as being needed to meet people’s needs. We found the provider had not ensured suitability trained and qualified staff were deployed in the home. This was because none of the staff working on some shifts had training in areas such as fire safety or first aid.
We found that the numbers of staff who had received training in certain areas had decreased since our last inspection. The induction for new staff was poor and we found some staff had started work in the home without a full induction.
The provider had not ensured that they acted in accordance with the Mental Capacity Act (2005) (MCA). As a result, we found that staff were sometimes making decisions for people without their involvement or consent. The registered manager had not identified that some people living in the home were potentially being deprived of their liberty. They had not acted in accordance with MCA Deprivation of Liberty Safeguards (DoLS).
People’s nutritional needs were not sufficiently supported. People at risk of malnutrition were not adequately monitored. Staff did not always appear to understand people’s nutritional needs and there was a lack of guidance for staff in this area. There was a lack of choice and involvement for people regarding their meals.
We saw examples of staff interacting with people in positive and caring ways but this was not consistent. Staff did not always respond to people or take action to protect their dignity. People and relatives, where appropriate, were not always consulted regarding their care.
The care provided was not always responsive to people’s individual needs or preferences. People and relatives did not have formal opportunities to review or discuss the care provided.
People’s care records did not have sufficient information or guidance in them. Care records were not reviewed or adjusted when people’s care needs changed to ensure the care provided was still suitable. We found the provider had not ensured there were accurate, complete, and contemporaneous records of people’s care.
There was mixed feedback regarding activities and whether they met people’s needs. There was a lack of activities for people who remained in their rooms and for those who were particularly at risk of social isolation.
Relatives told us they felt able to raise concerns and complaints. However, some felt there were limited opportunities to discuss the service provided and offer feedback. We found communication and transparency in the home could be improved. Some staff, and all the relatives we spoke with, had not been informed of the issues found at our previous inspection. There was a lack of consultation in terms of how improvements in the home should be made.
The provider had put in place some regular audits to help monitor and drive improvements. We found that these were not effective. Audits had not been carried out in some areas where we found that improvements were required. Some improvement actions the provider had identified as part of their action plan had not been taken. We found systems in place had not been effective at driving improvement or sustaining areas where no concerns were identified at the last inspection.
We were concerned that the culture and arrangements in the home did not ensure staff felt able to raise concerns regarding the service provided.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Ailwyn Hall provides accommodation and support to a maximum of 39 older people some of whom were living with dementia. It is not registered to provide nursing care. At the time of our inspection there were 34 people living in the home.
We last inspected this service on 16 and 23 October 2014 where we found that the service was not meeting the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations. The provider was in breach of the Regulation 10 which corresponds with Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014). This was because there was no effective system in place to assess and monitor the information contained in the home’s records. This included information contained in people’s care records.
Following the inspection in October 2014, the service sent us a plan to tell us about the actions they were going to take to meet the above regulations.
At our inspection in May 2016, we found 6 breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and 1 breach of the Care Quality Commission (Registration) Regulations 2009.. You can see what action we told the provider to take at the back of the full version of this report.
There was a manager in post who had been appointed in January 2016. At the time of our inspection, the manager had not submitted an application to the CQC to become a registered manager. 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 found that there were continuing issues regarding the governance and quality monitoring of the service. The provider’s quality monitoring had failed to identify issues regarding the documentation of people’s care needs. We found these were not always accurate or detailed enough. The manager did not have a full understanding of their responsibilities and had not always taken the required actions.
Staff were positive about the manager and the support they provided. Whilst not all issues within the home had been identified the manager had taken steps to address some issues and make some positive changes in the home.
People were not protected from avoidable harm and abuse because staff did not always identify and take action to manage situations that placed people at risk of this. Safeguarding incidents were not always reported to the relevant authorities.
Whilst the service identified some risks to people and took action to manage these, not all risks to people were adequately identified or managed. Staff did not always take action when they should to manage the risks associated with people who displayed challenging behaviour. There were frequently insufficient suitably skilled staff available to meet people’s needs and keep people safe.
People living in the service were not always receiving their medicines as prescribed and prescribed external medication was not stored securely. Other practices around medicines were followed safely.
Not all staff had received the training they needed in order to meet people’s needs. The manager did not have sufficient knowledge of the Deprivation of Liberty Safeguards (DoLS) and the home was not working within the requirements of the Mental Capacity Act 2005.
People and their relatives were complimentary about the quality of food provided. However, people were not always given the support they needed in order to eat and drink. Whilst some people were offered choice regarding their meals this was not always consistent.
The home ensured people had access to appropriate health care professionals when required.
Whilst staff knew people living in the home well and took steps to promote people’s dignity and independent they did not always behave in a kind way. We observed occasions where people were not treated in a kind manner and staff did not always take action to respond or relieve people’s distress.
There was not always enough stimulation and activities for people living in the home. There was mixed feedback regarding how much the service supported people to leave the home and access the local community. Relatives could visit when they wanted and the home welcomed engagement with relatives.
People received care that met their individual preferences. The home had identified a need to provide people and their relatives with formal opportunities to provide feedback and discuss their care, and were making arrangements to do so. People and their relatives told us they knew how to raise concerns and felt able to do so.
This inspection took place on 16 and 23 October 2014 and was unannounced. We carried out an inspection in July 2013 where there were breaches in two regulations. A follow up inspection was carried out in October 2013 and the home had taken the appropriate action to comply with the two breaches.
Ailwyn Hall is a residential care home providing care and support for up to 39 older people living with cognitive impairments such as dementia. The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People told us they felt safe and that staff supported them safely. Staff were aware of safeguarding people from abuse and would act accordingly. Individual risks to people were assessed and reduced or removed.
There were enough staff available. People, their relatives and staff members all said that staffing levels were high enough to allow staff members to spend time with people.
Medicines were safely stored and administered, and staff members who gave out medicines had been properly trained. Staff members received other training, although up to date records had not been maintained. Staff received supervision from the manager, which was supportive and helpful but were not frequent enough.
The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The service was meeting the requirements of DoLS. The manager recognised when people were being deprived of their liberty and was taking action to comply with the requirements of the safeguards.
Staff members understood the MCA and presumed people had the capacity to make decisions first. However, where a lack of capacity had been identified, there were no written records to guide staff about who else could make the decision or how to support the person to be able to make the decision.
People enjoyed their meals and were given choices. Drinks were readily available to ensure people were hydrated.
Health professionals in the community worked together with the home to ensure suitable health provision was in place.
All the comments we received were positive when talking about the staff team. We were told they were caring, kind, respectful and courteous. Staff members knew people well, what they liked and how they wanted to be treated.
The home did not properly monitor care and other records to assess the risks to people and whether these were reduced as much as possible.
People’s needs were responded to well and care tasks were carried out thoroughly. Care plans contained enough information to support individual people with their needs.
A complaints procedure was available and all of the concerns and complaints made in the last 12 months had been investigated and dealt with appropriately.
People, visitors, staff members and visiting health care professionals all said that the home was well led, that the manager was supportive and approachable, and that they could speak with her at any time.
We received an action plan in August 2013 and carried out this follow up inspection in October 2013 to see that the home had completed the actions stated in the action plan.
We found people were now supported to eat their meals appropriately and that medication was stored and administered safely.
The care and support offered to people was individual and informative. Risks had been assessed and action taken to minimise or remove the risks. Care plans had been reviewed monthly and with the families annually. Local medical support was regular and carried out by the same GP for continuity of medical support. People were offered the correct support to meet their care needs.
The home provided a choice of meals that was suitable for the varied needs of the people living in this home. What was not suitable was the methods used to support people properly to eat those meals that would ensure they had nutritious l meals.
The home was clean and good hygiene practices were promoted. The staff had suitable systems in place to prevent cross contamination and promote good infection control procedures.
Although some of the medication management was appropriate the administration and storage of medicines needed to be improved upon.
One of the methods we used was an observation tool called the Short Observational Framework for Inspection (SOFI). This is a specific method used for observing care to help us understand the experience of people who cannot talk to us. We spent time observing people who use this service over a period of two hours.