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Inspection report

Date of Inspection: 21 May 2014
Date of Publication: 4 July 2014
Inspection Report published 04 July 2014 PDF

Overview

Inspection carried out on 21 May 2014

During a routine inspection

We brought this home's scheduled inspection forward in response to concerns we received relating to support for staff in dealing with behaviours which challenged the safe delivery of care and support. One inspector carried out the inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

Bedrooms belonging to people accommodated in the home were personalised with photographs and pictures and the rooms were clean and tidy. A person showed us their bedroom and told us, "I like to spend time in my room and keep it clean." They told us the manager had bought them a new TV and radio. We saw evidence that systems were in place to ensure electrical and gas equipment in the home was maintained and serviced in safe working order.

The staff we spoke with were aware of the importance of risk assessment and the steps they needed to take to keep people safe from accidental harm. Incident records showed that a person recently admitted to the home had fallen out of bed soon after they moved in. In consultation with the person bed rails had been fitted to keep them safe from further risk.

Protective bumpers had been fitted to beds rails, where used, to minimise the risk of entrapment.

Care plans contained assessments of need and identified risks had been appropriately assessed. Clear guidance was in place for staff to follow in keeping people safe from accidental harm.

Suitable systems and protocols had been developed to make sure people living in the home received their medicines exactly as prescribed by their doctors. People who had been assessed as at risk of weight loss were receiving good support to maintain healthy weights.

Is the service effective?

We saw evidence of people being fully involved in the development of their care plans. These documents had been written in a person centred way, which meant that the specific needs of the individual were reflected in the care and support they received. However, we were concerned to find that a person admitted two months before our visit did not have a care plan. This placed them at risk of receiving inappropriate or unsafe care and support. The manager told us what action they intended to take to make sure each person had a basic care plan in place at the point of admission.

Is the service caring?

During our visit we saw staff interacting with the people they supported in a patient, caring and compassionate manner. We also saw staff offering comfort to a person who became distressed and responding to people's requests for information and guidance.

Care plans were detailed and emphasised the right of the individual to privacy, dignity, respect and independence. Clear written protocols in care plans guided staff on what they must do to provide safe care and support, such as health and nutritional monitoring.

One of the people we spoke with said, "I am treated with dignity and respect and I am able to choose what time I get up, go to bed, go out and what I eat. I like spending time in my room and I like to keep it clean and tidy. Nobody bothers me. It's much better than where I used to live."

Is the service responsive?

The home had a suitable policy and procedure for recording, investigating and responding to complaints. The people we spoke with told us if they had any concerns they would speak to a member of staff, the manager or provider. One person said, "I've never had to make a complaint. If something's not right you just have to speak up and it will get sorted."

We asked three people about their experience of living in the home. They told us they felt safe and they had good relationships with the staff providing their support. Two people praised the provider for installing a small kitchen so they could help themselves to breakfast, snacks and drinks at all times. Similarly, a flexible breakfast routine had been implemented to give people more choice and promote their independence. The three people we spoke with told us these changes had enabled them to be more independent and have more choice in relation to their daily routines.

Is the service well led?

The manager in post at the time of our visit had been registered with the Care Quality Commission (CQC).

Staff told us they were well supported and had access to training and regular supervision. In addition the staff we spoke with told us the manager was always available to discuss any concerns or issues.

We saw evidence of staff meetings and the nurse told us there was a handover of information at the start of each shift. This ensured all staff were kept up to date with important information.

There was a system of audits in place that included care plans, medication and health and safety.

We saw the home's record of incidents and accidents. Each incident or accident had been subject to review and follow up action to reduce potential risks to the health and safety of people living and working in the home.