Inspectors gathered evidence to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring, Is the service responsive? Is the service well led?
Below is a summary of what we found based on the evidence gathered during our inspection carried out on 09 April 2014. This included speaking with people who used the service, some of their relatives and members of staff who supported them and by looking at records.
The detailed evidence that supports our findings can be read in the full report.
Is the service safe?
We looked at records which showed that people's care and support needs had been assessed, documented and reviewed. They gave staff clear guidance on how to deliver safe and appropriate care that met people's individual needs. A GP with experience of the care and treatment provided at the home commented, 'Staff have a fantastic attitude and are genuinely caring. I am very confident that people are well looked after.'
We saw that care and treatment was provided in premises that were suitable and fit for purpose in terms of design and layout. We saw that the premises had been well maintained and were in a good state of repair and decoration both inside and out. However, we found that security arrangements were not as effective as they could have been because access to the premises was not restricted during daytime hours. The provider has agreed to review and improve existing security arrangements.
Effective recruitment policies and procedures had been put in place to ensure that staff employed at the home were of good character and appropriately skilled to meet people's needs. This included carrying out appropriate checks before staff began work.
Is the service effective?
At our previous inspection carried out on 12 November 2013, we found that some people had not been sufficiently involved in decisions made about whether or not resuscitation should be attempted in the event of a medical emergency. During our inspection carried out on 09 April 2014, we found that necessary improvements had been made and that the regulations in relation to how consent was obtained had been met.
People told us that staff had always obtained their consent and agreement about the support, care and treatment provided. One person who lived at the home commented, 'I have been fully consulted and involved about the care and support I need. I have agreed to it and frequently discuss my requirements with the manager, nurses and care staff.'
We saw that people had been involved in the assessment of their individual needs and in the planning, delivery and reviews of the care and support they received.
Is the service caring?
During our inspection we saw that staff treated people who lived at the home with respect and kindness while delivering appropriate levels of care and support. We also saw that care was delivered in a way that met people's individual needs and requirements.
People who lived at the home and their relatives were very positive and complimentary about the levels of care provided and the care staff who supported them. One person commented, "The care we get here is absolutely first class it really is. Everybody is so very well looked after in such a kind, patient and efficient way. Staff come quickly when you call for then and can never do enough for you.'
Is the service responsive?
People told us they liked the opportunities provided by the activities coordinators and the range of facilities available at the home. These included computer games, poetry sessions, flower arranging and gardening, arts and crafts activities and use of a music room, hairdressing salon and library.
We saw that people had been given information about how to make a complaint if the need arose and that concerns raised had been properly documented and resolved in a prompt and effective way. Everybody we spoke with told us they knew how to make a complaint but had not had the need to do so.
Is the service well led?
We found that effective systems had been put in place to assess and monitor the quality of services provided and to identify, assess and manage risks posed to the health, welfare and safety of people who lived at the home.
We saw that the home worked well with healthcare professionals such as GP's, dentists and chiropodists to make sure that people received care that met their individual needs in a joined up way.
We spoke with members of staff who told us that both the provider and manager demonstrated strong, visible and consistent leadership in a way that made them feel valued and supported.