Archived: Cassini House

The focus of the inspection was to gather evidence to answer the five questions : is the service safe, effective, caring, responsive and well-led?

Is the service safe?

The provider had ensured that staff planned and delivered people's support effectively. There were sufficient staff who were suitably qualified, skilled and experienced to meet people's needs on a day-to-day basis. However, a relative told us there had been a high turnover of staff and the registered manager told us two staff vacancies existed in a full team of ten staff members until the latest recruitment round.

The service handled and reported safeguarding concerns effectively and had raised a Deprivation of Liberty Safeguards (DoLS) issue with the local authority. We found several staff had not received Safeguarding of Vulnerable Adults training and the training matrix we were shown for the period July - December 2014 did not show training was planned in this subject.

The environment in which people lived was clean and generally safe. However, we observed there were several flights of stairs for some people to use to get to and from their bedrooms. Risk assessments had not been undertaken in regard to people living on upper floors.

Is the service effective?

The service was effective because it took the necessary steps to ensure people were well supported. Relatives who spoke with us said the needs of their relatives were met. A person using the service spoke with us and said their needs were fully met. The service was concerned with people's welfare, for example by ensuring people who might come into conflict with each other were re-directed to ensure that such conflicts had not occurred. The service also made reasonable adjustments to ensure people were well supported. Staff had considered the issue of people's capacity and incorporated this into their day-to-day support.

Is the service caring?

The staff were seen to be caring towards people using the service. We observed staff interacted with all of the people who used the service in a respectful manner and staff adjusted their methods of communication to ensure they communicated effectively with people who used non-verbal communication. A person we spoke with who used the service said they felt safe and the relatives we spoke with said they felt their family members were safe.

The service had clearly focused upon ensuring that people's specific needs were well met and had provided staff with training to ensure they had sufficient skills to fully meet people's specific needs, for example training in providing support for people with an autism spectrum condition.

Is the service responsive?

We saw evidence the service responded positively to situations which could cause difficulty for people who used the service. For example, the staff ensured clothes were readily available downstairs if a person who used the service removed their clothing. A relative also described how the service had really helped their family member to lose weight by working in partnership with the person's general practitioner (GP) and the dietician they were referred to.

The service had made use of other staff to ensure it continued to provide effective staffing levels when they had two staff vacancies.

Is the service well-led?

There were effective monitoring systems in place to ensure the quality of the service was maintained and these were effectively monitored by the registered manager. It was clear to us staff liked working with the registered manager.

Care workers provided care in a respectful and friendly manner. One person told us that the service was 'good'. We spoke to one relative who told us they found their relative was welcomed into the home and some members of staff were excellent.

We looked at three care plans. We saw that they were up to date and reflected the needs and preferences of the residents. We saw up to date risk assessments which reflected the current needs of the residents at Cassini House and which were reviewed regularly with risk management plans to ensure that people's needs were being met.

We checked the kitchen and store cupboard and saw that a variety of food was available. We saw that people made choices about what they wanted to eat and we looked at records which showed what people had eaten. People were offered varied and nutritious food.

People were cared for in a clean and hygienic environment. Most care workers had had training about infection control and prevention.

We saw that Cassini House had a number of mechanisms to make sure that the quality of service was maintained and improved. We saw that there were both internal and external checks on standards of care and the organisation responded to issues which were raised.

We observed staff interacting with people using the service during the day and when they returned from the day centre. We saw them interacting in a friendly and kind manner. Where necessary they were following guidance on interacting with people as outlined in the person's care plan.

There was evidence that people or their relatives were involved in planning their care and we saw evidence that people had their needs assessed and that their care was being delivered in a way that met these.

We looked at the processes for managing medications. All mediations administered had been recorded appropriately.

The provider had a system in place to manage complaints and information on how to do so was available in a range of formats including easy read.