Background to this inspection
Updated
3 November 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Prior to our inspection we reviewed the information we held about the service. This included notifications we had received from the provider and other information we hold about the service including, any safeguarding alerts and outcomes, complaints and inspection history. Notifications are information about important events which the service is required to tell us about by law. The provider had not been asked by us to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
The inspection took place on 1 and 3 August 2017 and the first day was unannounced. The inspection was carried out by two inspectors and a pharmacist inspector.
We spoke with 11 people using the service and seven of their relatives or representatives. Due to their needs, some people were unable to share their direct views and experiences. Along with general observation, 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.
We spoke with the registered manager, six members of care staff, the activities co-ordinator, chef, office administrator and operations manager. We also spoke with four visiting health and social care professionals. We reviewed care records for eight people using the service. We checked staff records for three staff members recruited in the past six months. We looked around the premises and at records for the management of the service including quality assurance systems, audits and health and safety records.
We looked at the systems in place for managing medicines. We spoke to staff involved in the governance and administration of medicines. We examined seven medicines administration records (MARs) and observed medicine administration for five people.
Following our inspection, the registered manager sent us information we had requested about staff training, quality assurance audits, findings and planned improvements.
Updated
3 November 2017
This inspection took place on 1 and 3 August 2017, the first day was unannounced.
At our comprehensive inspection on 6 September 2016, we found the provider was not meeting the regulation in respect of medicines management. We also identified improvements were required around the home’s quality assurance processes and the submission of statutory notifications as required by their CQC registration. Following the inspection, the provider sent us an action plan which set out the action they were taking to meet the regulations. At our next inspection in December 2016 we found the provider had met the breach although we identified some improvements were needed in relation to the recording of topical medicines and the management of ‘as required’ medicines.
The home provides care and accommodation for up to 36 older people, some of whom may be living with dementia. This service offers respite care breaks as well as long term residential care. There were 34 people using the service at the time of our inspection.
Although we undertook this inspection as part of our planned inspection programme, we also received some information of concern about the service. This related to staffing levels, staff using unsafe moving and handling techniques and people not being given choice around their morning routines. We looked at these issues during this inspection and found no concerns.
We found there were improvements with the ways medicines were managed. New audits and checks were in place although further work was required to embed and sustain consistent safe practice for the recording of people’s medicines. We have made a recommendation about medicines management.
People felt safe and well cared for. Risks to people’s health and well-being were assessed and kept under review. Staff took action to minimise these risks and keep people safe. Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse.
The environment was safely maintained and people had the equipment they needed to meet their assessed needs. People’s bedrooms were personalised and furnished to comfortable standards.
At the time of our inspection there were enough staff to meet people’s needs and keep them safe. Staff received ongoing training and support to fulfil their roles and keep their knowledge and skills up to date.
People had clear assessments of their needs and plans were in place to meet them. Information was communicated well within the staff team and people's care plans were reviewed regularly. The home worked well with other professionals and people were supported to access the healthcare services they needed.
There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People were encouraged and supported to eat and drink well. When people were at risk of poor nutrition or dehydration, staff involved other professionals such as the GP or dietician.
There were positive and caring relationships between staff and people who lived in the home and this extended to relatives and other visitors. People maintained important relationships with family, and relatives felt involved in the care and support their family members received.
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.
Staff were caring, respectful and made sure people’s privacy and dignity were maintained. People and their relatives were supported sensitively during end of life care.
People continued to benefit from an extensive range of activities in and outside the service which met their individual needs and interests.
There was an open and inclusive atmosphere in the service and the registered manager showed effective leadership. Staff were clear about their roles and responsibilities and felt supported by her and each other.
People and their relatives were encouraged to express their views and opinions. They knew how to complain and make suggestions, and were confident their views would be acted upon. The provider had a complaints procedure to support this.
The provider had good oversight of everything that happened at the home. Management and staff completed regular audits to check the quality and safety of the service. Where improvements were needed or lessons learnt, action was taken.