Archived: Victoria Highgrove

Our inspection team was made up of one inspector. We answered our questions; Is the service effective? Is the service responsive? Before the inspection, we reviewed information we held about the service. This included previous inspection reports, and any notifications, (A notification is information about important events which the service is required to send us by law) and complaints we had received.

Below is a summary of what we have found. The summary is based on our observations during the inspection. On the day of the inspection 20 people were living at the service. We observed the care provided, looked at supporting care documentation, staff records and records relating to the management of the service. We spoke individually with the registered manager (who is referred to as manager in the report), two registered nurses, the chef and three physiotherapists. We spoke with six people who used the service and three relatives/friends. We also spoke with the local authority commissioning team, and the clinical commissioning group (CCG) to ask them about their experiences of the service provided.

Is the service effective?

People were treated with respect and dignity by the care workers. People told us they were safe in the service.

Staff had received training and had an understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They knew who to contact should further guidance and support be required.

Staff training was available to support staff to undertake their roles in the service. This helped to ensure people were not put at any unnecessary risk.

People's health and care needs had been reviewed and where possible people and their representatives had been involved in the writing and review of the care documentation. Their specialist care needs such as dietary requirements and support needs had been identified. People were able to move around the service freely and safely.

Is the service responsive?

People had been supported as part of their rehabilitation to meet their agreed goals. People told us they had guidance and regular support from the physiotherapists, and occupational therapists. These specialists had worked with them to improve their mobility before returning home. They told us of the exercises they were being supported to undertake.

There was a system in place to make sure that the provider, management and care staff learnt from events such as incidents and accidents, complaints, and concerns.

Below is a summary of what we have found. The summary is based on our observations during the inspection. 20 people were resident in the service at the time of our inspection. We observed the care provided, looked at supporting care documentation, staff records and records relating to the management of the service. We spoke individually with the registered manager (who is referred to as manager in the report), a registered nurse, a physiotherapist, an occupational therapist, a physiotherapist and occupational therapist assistant, a case manager, a senior care worker, two care workers and a new care worker who was shadowing, a domestic assistant and the chef. We spoke with 12 people who used the service.

Is the service safe?

People were treated with respect and dignity by the care workers. People told us they were safe in the service. Comments received included, 'They help me when I need anything,' and 'I have just been happy here. I have been safe and they have looked after me.'

Staff had received training and had an understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They knew who to contact should further guidance and support be required to ensure people's best interests. People had been asked for their consent for any care or treatment.

There was a system in place to make sure that the provider, management and care staff learnt from events such as incidents and accidents, complaints, and concerns.

Staff training was available to support staff to undertake their roles in the service. However, changes in the training provided had led to not all the staff being up-to-date with all the required training. Systems had been developed with recording and monitoring systems put in place. This helped to ensure people were not put at any unnecessary risk.

A staff rota was in place, which had taken into account people's care needs when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were met.

Is the service effective?

People's health and care needs had been reviewed and where possible people and their representatives had been involved in the writing and review of the care documentation. Their specialist care needs such as dietary requirements and support needs had been identified. However, not all the care and support documentation had been updated as people's care needs had changed. This had not ensured safe and consistent care was always provided, and up-to-date guidance for staff was not in place to follow. People were able to move around the service freely and safely.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and offered encouragement when supporting people. Comments received included, 'They help me when I need anything. They are very good and kind,' They are very good,' 'They are very kind,' and 'Yes they are very good. '

People had been asked to complete quality assurance satisfaction surveys.

People's preferences and diverse needs had been identified. People told us care and support had been provided in accordance with people's wishes.

Is the service responsive?

People had been supported as part of their rehabilitation to meet their agreed goals. People told us they had guidance and regular support from the physiotherapists, and occupational therapists. These specialists had worked with them to improve their mobility before returning home. They told us of the exercises they were being supported to undertake. One person commented, 'To begin with the physio came around to get me on my feet. They are now not coming back.'

There was a complaints policy and procedure in place if people or their representatives were unhappy, which was monitored by the provider. People told us they had not had to raise any concerns, and they were aware who to speak with if they had any concerns and that they felt they would be listened to. People could therefore be assured that complaints were investigated and action taken as necessary.

Is the service well lead?

The service had quality assurance systems to develop and improve the service provided, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all time.

This told us people's care needs had been assessed and reviewed, and care and treatment had been planned and delivered as detailed in their individual care plan. Comments received from people who used the service included 'I appreciate being here very much,' 'They (the staff) are all very nice, and quite jolly,' 'I couldn't have been brought to a better place,' 'It's wonderful. They (the staff) are very helpful, 'I love it,' 'They (the staff) have been marvellous,' and 'Nothings too much trouble.'

Infection control policies and procedures were in place to protect people. All the people we spoke with told us they thought the service was kept clean. They could remember care staff wore gloves when providing personal care.

Appropriate arrangements were in place in relation to obtaining, storing, administering and recording medication. All the people we spoke with confirmed their medication was administered appropriately and on time.

People's care had been provided by care workers who understood their care needs. There were sufficient numbers of staff with the right skills and qualifications to meet the needs of the people who used the service. Records and processes in place ensured staff who worked in the service had the right skills and qualifications to undertake the role designated. Staff had training and development opportunities and told us they were well supported by the provider and staff that they worked with.

We found that the processes in place to respond to complaints had ensured information provided was used to improve the service.

Before people had received any care or treatment they had been asked for their consent and staff had acted in accordance with their wishes.

People's care needs had been assessed and reviewed, and care and treatment had been planned and delivered as detailed in their individual care plan. Comments included 'It's like the Grand Hotel here,' 'I feel safe here,' and 'I am exceptionally happy here.'

People were protected from the risks of inadequate nutrition and dehydration. The food provided was well presented and seen to be of a good quality. Comments included 'The food is marvellous,' and 'Excellent food.'

Appropriate arrangements were in place in relation to obtaining, storing, administering and recording medication.

Robust recruitment practices had been followed. Appropriate identity and security checks had been completed as part of the recruitment process.

The records needed for the management of the home had been maintained and were accurate and complete.