Archived: Canwick House Care Home

There were 14 people living in Canwick House Care Home on the day of our inspection. One person was in hospital.

We spoke with the provider, the cook, the housekeeper and two members of care staff. We also spoke with three people who lived at the service and one relative.

We considered the findings of our inspection to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Is the service caring ?

People told us they were well cared and were happy living at the service. A relative said, 'The staff are good, you can't fault them.' One person said, 'I'm happy, I have my papers to read.'

However we saw that the provider had made decisions with regard to the care of people using the service which did not take into account their wishes or needs.

Is the service responsive?

We spoke with one person and their relative and found that they had not been involved in any discussions about what was in the person's best interest. We found that they had recently moved bedroom at the provider's request and the reason for this was not recorded in their care file. This action was not responsive to the person's needs.

Is the service safe?

We found that the medication fridge temperature recordings were out of the safe normal range needed to maintain medications that no action had been taken to correct this or to store the medication at a safe temperature.

We saw that previous concerns about care staff competency to safely administer medication had not been addressed. The provider was unable to show us evidence that staff had had their competencies checked.

We saw that a bath in one person's bedroom was being used inappropriately. We found a commode basin soaking in their bath. We noted that the service did not have sluice to enable the safe cleaning of commodes.

We found several fire doors were propped open. This meant that the fire doors would not close automatically in event of a fire and offer protection to people and staff.

Is the service effective ?

We saw that one person did not have their needs assessed and their care plans did not always address their individual care needs.

Is the service well led?

Staff told us the acting manager was approachable and they had seen improvements since they took up their post in 2013.

However we found that the provider had made decisions about care people received without involving the person or member of care staff.

We considered the findings of our inspection to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found-

Is the service caring?

We saw how members of staff treated people and we observed care. We saw that care was delivered effectively. When staff delivered care we found that it was provided in a respectful manner. We saw that staff encouraged people to be independent.

When they supported people staff showed patience and we observed that they supported people at the person's own pace.

We spoke with a relative who told us that the home provided care which met their family member's needs.

We spoke with three people who lived at the home. One person said, 'People (staff) bring me things if I need them.' Another person reported that, 'Always ask me what I want for meals.'

Is the service responsive?

We saw that people's individual physical, mental and social care and support needs were assessed and met by staff. This included people's individual choices and preferences as to how they liked to spend their day and receive their care.

We observed that staff responded to people in a positive manner and respected their individual preferences. For example, staff asked people what they would like for lunch and where they wanted to eat their meal.

We observed that staff obtained people's consent before they carried out any care.

People had access to other professionals such as GP and chiropodist's in order to meet their needs.

Is the service safe?

Risk assessments regarding people's care were carried out and measures were in place to minimise these risks.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards in place. Mental Capacity Act (2005) and Deprivation of Liberty Safeguards are laws which protect people who are unable to make decisions for themselves. At the time of our inspection no one was deprived of their liberty.

We found where people lacked mental capacity their best interests had been considered by staff, however the records did not always specify the areas which the best interest decisions related to.

The service was safe and areas within the home were clean. The home was well maintained therefore not putting people at unnecessary risk. However, there were areas within the home which were not fit for purpose. For example the laundry area and the cellar area which was used for food storage.

When we looked at how medicines were administered to people we found that the processes for recording and storage of medicines were not always followed.

Equipment was properly maintained and suitable for purpose.

Is the service effective?

Our observations found that members of staff knew people's individual health and wellbeing needs. There was a process in place to ensure that staff were aware of people's changing needs.

We observed that staff responded to people's needs in a timely manner. When we spoke with people they told us that they did not have to wait long for staff to attend to them.

Arrangements were in place to ensure that people's physical health needs were met. For example, where people had specific issues with their health, such as the need for oxygen therapy, the care plans included guidance on how to deliver the care.

We found that repositioning charts and records of comfort checks for people who were unable to use their call bells had been completed fully.

Is the service well led?

Staff said that they felt supported and trained to safely do their job. Training plans were in place to ensure that staff had the appropriate skills to meet people's needs.

Quality assurance systems were in place and people were listened to. Staff told us that they felt able to raise issues and that these were acted upon by managers. We saw satisfaction surveys had not been carried out with people who lived at the home and their relatives. We spoke with a relative who told us that they felt able to raise issues and if they needed to complain they would know how to do this.

At the time of our inspection there was not a registered manager in post. The acting manager told us that they had applied to become the registered manager and were awaiting the outcome.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities. Staff told us there were enough qualified, skilled and experienced staff to meet people's needs.

We saw people were treated with dignity and respect. Care and treatment was planned and delivered in a way that ensured people's safety and welfare.

We looked at people's nutritional needs and saw people received a nutritious and varied diet. People told us they liked the food. They said, "The food is very good."

People told us they liked living at the home. We observed staff interacted well with people and provided support to them.

We spoke with a visitor who told us their relative was getting good care.

We observed procedures for the administration of medicines and found there were safe and appropriate policies and procedures in place.