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Inspection report

Date of Inspection: 2 July 2014
Date of Publication: 20 August 2014
Inspection Report published 20 August 2014 PDF

Overview

Inspection carried out on 2 July 2014

During an inspection looking at part of the service

People at the home had complex needs and were not all able to tell us about their experiences at the home. In order to get a better understanding we observed care practices, looked at records and spoke with staff. During the inspection we spoke with the manager and six members of staff. We sat in on two workshop groups and spoke with some of the people who used the service.

At the time of the inspection there were 32 people who lived at the service.

Our inspection team was made up of one adult social care inspector. We answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and support was planned and delivered in a way that was intended to ensure people�s safety and welfare. Risks to people who used the service had been identified and there was information on how to manage and minimise risks.

We found that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. Some medication was not clearly labelled and there was not an effective system to ensure that medicines were disposed of appropriately. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

We found that a lack of appropriate employment checks meant that the provider could not be certain that people were cared for, or supported by, suitably qualified, skilled and experienced staff. There were gaps in the background checks for the recruitment of staff which included inadequate references and insufficient proof of identity. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

People were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained. Some records relating to the people who used the service were not clear and there was no consistent approach to the management of records.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

It was clear from what we saw and from speaking with staff that they understood people�s care and support needs and that they knew them well. People were able to take part in activities of their choice. The activities on offer supported people in developing their skills and independence.

We found that the staff understood the requirements of the Mental Capacity Act 2005 and carried out decision specific mental capacity assessments and best interest meetings when needed.

Is the service caring?

People were supported by committed and caring staff. We observed that people appeared comfortable in the service and familiar with the staff that worked there. We saw that staff members spoke directly with people and supported them at an appropriate pace. We observed that people were treated with respect and dignity. The people we spoke with told us they liked living at Nutley Hall. One person said "I am well looked after".

Is the service responsive?

People�s needs were continually assessed and reviewed. Records confirmed people�s preferences, interests, goals and diverse needs had been recorded and support had been provided in accordance with people�s wishes. People's needs were reviewed to make sure that changes in needs were identified and action taken.

Is the service well-led?

The manager had been in post for two months and was still becoming familiar with the management systems of the service. There were a number of senior staff responsible for different areas of the service such as medication, training and recruitment. We found that there was no clear oversight of these systems which meant there was a lack of consistency. We spoke with the manager about this who agreed that this needed to be improved.