Background to this inspection
Updated
11 May 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We undertook an unannounced inspection of Appledale Cottage on 12 January 2016, 25 and 26 February 2016 and 17 March 2016. This inspection was done to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on 1 June 2015 had been made. The team inspected the service against the five questions we ask about services: is the service safe, effective, caring, responsive and well led. This is because the service was not meeting some legal requirements.
The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the home and looked at the notifications they had sent us. A notification is information about important events which the provider is required to send us by law.
The inspection team consisted of three inspectors, a pharmacist inspector and a specialist advisor. During our inspection we spoke with four people who used the service the registered manager and three staff. We also spoke with one GP and four relatives by telephone and received written feedback from four relatives.
We looked at four care records, medicine records, staff training certificates, four staff recruitment files and quality audits. We spent time in the communal areas of the home to see how people were supported and how staff were with people.
Updated
11 May 2016
We carried out an unannounced comprehensive inspection of this service on 12 January 2016, 25 and 26 February 2016 and 17 March 2016.
The home is registered to provide accommodation and personal care for adults who require nursing care and who may have a dementia related illness. The home is jointly owned and one owner is also the registered manager. A maximum of ten people can live at the home. There were seven people living at home on the days of the inspection. There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection on 1 June 2015 we asked the provider to take action to make improvements in how people consented to their care and how the provider records reflected the care people received to ensure that it met their needs. The provider wrote to us to say what they would do to meet legal requirements and this action had been taken.
People felt safe in the home and relatives told us that they felt assured their family members were supported in a safe way with staff that helped to keep them safe. Staff told us about how they kept people safe from the risk of potential abuse. During our inspection staff were available for people and were able to support them by offering guidance or care that reduced their risks. People told us they received their medicines as prescribed and at the correct time. They also felt that if they needed extra pain relief or other medicines these were provided. People told us there were enough staff to support them when they needed or wanted help or assistance.
People told us staff knew what care they needed and relatives felt assured the staff were trained in how to look after the needs of people who lived at the home. All staff we spoke with felt supported by the manager and were able to discuss their role or training needs.
People told us they enjoyed the food and that it was well prepared and always available. Where needed people they were supported to eat or had their meal prepared in an alternative way such as softer options. People had not always been involved in the planning of their care due to their capacity to make decisions. However, relatives felt they were involved in the care of their family member and were asked for their opinions and input. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.
Staff developed positive, respectful relationships with people and were kind and caring in their approach. People told us and we saw that their privacy and dignity were respected and staff were kind to them. People received supported to have their choices and decisions respected and staff were considerate of promoting their privacy and dignity. Staff anticipated people’s care needs and attended to people in a gentle and unhurried way.
People told us they had chosen to maintain their hobbies and interests and we saw people were happily knitting, reading or listening to music. Staff offered encouragement and supported people to go out on trips with friends and local community groups.
People and relatives we spoke with told us they would happily raise any complaints with the registered manager. However they had not needed to follow or use the provider’s complaints policy as they were happy with their care.
Management and staff had implemented recent improvements to record keeping which showed how they made changes to people’s care or medicines. These would need to be regularly reviewed to ensure people’s care and support needs continued to be met. People and relatives felt they were involved the home and that it suited them well. The registered manager regularly checked that people and their family members were happy with their home and care. The management team were approachable and visible within the home which people and relatives liked.