A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
We saw evidence that there were enough suitably trained and experienced staff to meet the needs of the people who used the service. The owners of the service ran and managed the home on a 24-hour basis. They had however, two voluntary staff that assisted as required. Both of these people had the necessary recruitment checks and relevant training and education.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.
Medicines within the service were effectively managed. This meant that they were correctly handled, administered, stored and disposed of to minimise the potential for error and ensure people received the correct medicine.
There were effective and embedded arrangements in place for reporting incidents and accidents with evidence that learning from incidents and accidents took place. The provider explained that they took the necessary actions to help reduce the risk of a potential reoccurrence.
There were effective procedures in place to manage and mitigate foreseeable emergencies including fire and loss of utilities. This meant that potential risks to the service were anticipated and planned for in advance.
We reviewed the audit schedule for the service and noted that there were appropriately completed risk assessments for both service provision and the environment. The provider had an effective system in place to ensure the reliability of systems, processes and operating procedures. These included infection prevention and control, health and safety and the layout, cleanliness and maintenance of facilities and building.
Is the service effective?
People told us that they were happy with the care and support they received and felt their needs had been met.
People's care records showed that their needs had been comprehensively assessed and that care and treatment was planned and delivered to ensure their safety and welfare. The records were regularly reviewed and updated. This meant that staff were provided with up to date information about how people's needs were to be met.
Care plans were person-centred and aimed to promote the person's independence and inclusion into the community.
People's capacity to consent was assessed in line with the Mental Capacity Act 2005. There was evidence that people made as many decisions as they could for themselves.
People's consent was obtained before any care or support was given and people had signed their care plans and risk assessments to state that they agreed with them. One person said, 'Yes, I get to choose what I do. I can make my own mind up'. We saw evidence that people had been asked to give consent for the recording and sharing of their information with other health and social care professionals.
Is the service caring?
One person who used the service said, 'I am very happy living here. It's really nice. I love the garden and have helped with the plants'. Another person said, 'I like it here and my room'.
People were cared for and supported by kind and attentive staff. The staff had compassionate attitudes and it was evident that they had built positive relationships with the people who used the service.
The staff knew the individual needs of people and this was observed during their interaction with them. Staff allowed people the time they needed to understand the information that was being given to them. This ensured that people had enough time to make their own decisions.
People's preferences, interests and beliefs were documented in their care plans. We saw evidence that these were accommodated by the staff. There was significant importance placed on meeting people's emotional and social needs, and this was done in a respectful manner.
The staff had effective communication skills and communicated in a way that people could understand. Their communication was appropriate and respectful.
The service questionnaires returned by people who used the service and their family and friends all stated that the staff were caring and supportive. One comment said, 'I can only say that everything you do is perfect'.
Is the service responsive?
There was strong evidence of the provider effectively working with other health and social care professionals to respond to the varying needs of people. People's care records included relevant information from other agencies to ensure that all agencies responded together in order to meet the person's physical, mental health and social needs.
People who used the service made their own choices as to what activities and leisure interests they wanted to pursue. The staff were responsive to these preferences and assisted the people to undertake their interests whilst maintaining their safety.
People were encouraged to maintain their relationships with their family and friends. One person's friend had spent Christmas day at Two School Cottages. This demonstrated that the provider had responded to a person's wish to spend the day with their best friend.
The care planning demonstrated a high level of understanding in relation to the vulnerability of the people who used the service. Care and support plans responded to this by ensuring people's safety and welfare were paramount at all times, as well as encouraging and promoting people's independence as safely as possible.
The service had an effective complaints procedure in place. We reviewed the minimal complaints the provider had received, and saw that where people had raised concerns, appropriate actions had been taken to address concerns and where possible, to the satisfaction of the complainant.
Is the service well-led?
During our inspection we saw evidence that the provider prioritised safe, high quality and compassionate care. Equality and diversity were promoted. We noted that there were effective communication strategies between the owners of the home and their relief staff. The satisfaction questionnaires returned by the relief staff showed high satisfaction with the owners and positive comments about their managerial and leadership skills.
The service had quality assurance systems, audits and records seen by us. These showed that showed identified shortfalls were addressed promptly.