Last updated 25 January 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This inspection took place on 13 November 2017 and was unannounced. We also returned on the 14 and 15 November 2017. We told the registered manager and chief executive officer (CEO) about the other dates. This was because we needed to spend specific time with them to discuss aspects of the inspection and to gather further information.

On the first day of our inspection visit, the inspection team consisted of one inspector, one specialist nurse advisor and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was for sensory impairment. On the second and third days of our inspection visits, there was one inspector.

Before the inspection, the provider completed 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 any improvements they plan to make. We reviewed information we held about the service, including safeguarding concerns shared with us from the local authority, previous inspection reports and notifications of significant events the provider sent to us. Notifications are events that the provider is required by law to inform us of.

Due to the nature of people's complex needs, we were not able to ask everyone direct questions. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us. We spent time observing people in areas throughout the home to see interactions between people and staff. We observed people as they engaged with their day-to-day tasks, the care they experienced, including the breakfast and lunchtime meal, medicines administration and activities.

We spoke with seven people who lived at the service, the CEO, senior executive officer (SEO), registered manager and deputy manager. We spoke with eight care staff, two senior carers, the health and safety officer, the cook, kitchen assistant and craft instructor. We also spoke with a visiting district nurse and two GPs.

We looked at the care plans and associated records for 10 people. We looked at four people’s medication records. We reviewed other records, including the provider's internal checks and audits, staff training records, staff rotas, accidents and incidents, menu’s, relative questionnaires, and health and safety checks. Records for four staff were reviewed, which included checks on newly appointed staff and staff supervision records.