At this visit we inspected medication storage for each of the five units. We assessed medication management procedures and administration.
We found that the home was meeting the requirements of the regulation. Medication was appropriately stored, and safe administration procedures were being followed for the benefit of people living in the home.
We found that people living in the home were generally content and felt comfortable living in the home. One person said to us 'I like it here, everyone is kind and friendly'; and a relative said 'This is a very good home and the care is first class.'
We found that the home provided a variety of activities for people to take part in. People who stayed in their own rooms had contact from staff on a regular basis.
We found that care planning documentation reflected the health and personal care that people needed, and was appropriately checked and agreed with people or their next of kin.
We inspected medication management and found that while most procedures were satisfactory there was also some evidence of poor practice.
We found that staff training practices were satisfactory, but some staff lacked suitable training in dementia care and found it difficult to meet the needs of people with dementia. This staff training issue was being addressed.
The home had monitoring processes in place to check the on-going effectiveness of the standards of care in the home.
The visit was carried out by two Inspectors over five hours, and one Expert by Experience. The Expert by Experience concentrated on talking to people about their life in the home, and observed how people were being cared for. During the inspection we talked with 18 people living in the home, three visitors, and 14 staff.
We received mixed views from people about their care and life in the home. Visitors spoke positively about the home, and said that 'Staff are very caring and helpful'; and 'Staff always keep us informed of any changes in our relative's condition.' Some people who were able to express their feelings about the home said that they were happy in the home. Some people said that staff were not always available to take them to the toilet; and some said that they were not given a choice of food.
Many people were unable to express themselves clearly due to dementia. We observed that some people were taking part in activities and were enjoying these together; but other people were left without stimulation.
We found that care plans generally provided a good overview of people's needs, but did not always provide specific details to enable staff to give effective care.
We found that staff training was not up to date for all required subjects; and not all staff had been trained in dementia care.
During the visit we (i.e. CQC) carried out a 'Short Observational Framework Inspection' which is a method of observing the ongoing life in the home over a set period of time. This is particularly helpful for observing care in areas where people are unable to express themselves clearly, because they lack mental capacity.
We visited each unit, and talked with people throughout the home, in communal areas, and in their own rooms. This included chats with eight people in the ground floor nursing unit who had full mental capacity. We met or chatted with another twelve people who had varying levels of dementia.
We also talked with four relatives or visitors, and a health professional. People mostly spoke positively about the home.
Comments from people living in the home included:
'They definitely look after us very well.'
'The staff are lovely, all very kind.'
'The staff come when I ring my bell ' no problem. They do everything I ask.'
At 6.45am we heard another person ask 'can I get up at'. The staff member said 'no not yet, wait until later'. The person then said 'my bed is soaking wet and I'm uncomfortable' and the staff member said 'I'll get someone to help you, but you don't normally get up until after breakfast.' We saw that another staff member then went in to help the person wash and dress. We asked people that were already dressed if they had been given the help they needed that morning. They said they had been helped to have a wash.
People told us that they did not usually have a choice of meals, but that the staff chose for them. One person said they were usually happy with what they were provided with and others said they were generally happy with the meals. One person said the meals were 'varied and well cooked and always quite delicious'. Two people were having breakfast in the lounge on one of the units and they told us this was their choice. One person said they preferred it as it was quieter there and they could read their books.
People told us that they felt safe in the home. They said that the staff treated them well and that they could talk to someone if they were worried about any part of their care. People told us that they liked the staff that supported them and that the staff treated them well. One person said 'the staff are great'.