29 April 2014
During a routine inspection
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read our full report.
Is the service safe?
People told us they felt safe. We saw that the provider responded to concerns and worked with other authorities in order to investigate safeguarding concerns. This meant that the provider responded to concerns in order to keep people safe.
Care records showed that risks to people had been identified. However not all care plans contained sufficient information to ensure that staff were able to provide care which kept people safe from the risk of harm. The provider did not monitor what people eat in order to ensure they were meeting people's nutritional needs.
People were cared for in an environment that was safe, clean and hygienic. The provider conducted regular maintenance checks and audits. People, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider had a system to ensure medicines were managed and administered safely.
People had their health and welfare needs met safely. We found that there were generally sufficient numbers of staff on duty because the provider used agency staff or permanent staff worked overtime to provide cover when necessary. However there was evidence that the provider could not on some occasions provide enough staff to deal with unexpected staff absences or increased care needs in a timely manner. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring people's safety.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, we found that proper policies and procedures were in place should they ever need to do so. Relevant staff have been trained to understand when an application should be made, and how to submit one.
Is the service effective?
Where necessary risk assessments had been undertaken and were used to help staff provide appropriate, safe and consistent support to people living in the home. Care plans contained information and guidance about people's specific conditions to enable care staff to meet the individual needs of the people who used the service. Records showed that people received the correct medicines at the required times. However care records needed further detailed information in order to support staff to deliver personal care in accordance with people's specific needs.
The service supported people's human rights. We saw that people living at the home regularly visited people that were important to them and made trips into the community.
People who used the service were asked to comment on the service provided, this included questions about the support they received. Information was provided to people in ways which met their communication needs.
Is the service caring?
Through observation and from speaking with staff it was apparent that they genuinely cared for the people they supported. We saw staff speak to the people with warmth, dignity and respect. When a person asked for something or support with their care needs we saw that staff responded quickly and effectively.
We spoke with five people who used the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example one person told us, 'I like them, they look after me very well'.
People were supported to engage in the local community and practice their specific faiths and beliefs. The manager and staff told us that people had not been offered as many activities as usually in the last few months but more activities were now being offered.
Is the service responsive?
People were supported to comment on the care they received at regular meetings and were given information in a format which met their communication needs. People told us that the provider made them feel comfortable about raising their concerns. A person who used the service told us, 'We can feedback how we feel'.
The service worked well with other agencies and services to make sure people received care in a coherent way. People were supported to attend doctors, dentists and other health appointments when needed.
Is the service well-led?
The provider regularly sought the views of the people who used the service. We saw evidence that they had introduced changes to how people were supported in response to comments received.
Staff had a good understanding of the ethos of the home and the quality assurance processes that were in place. We saw that there were meetings with staff to discuss quality issues and this helped to ensure that people received a good quality service at all times.
The service had a quality assurance system. However the provider had failed to respond appropriately when these systems had identified there was a risk that the care and welfare needs of the people who used the service were not being met. These included a lack of detailed notes in people's care records, reduced activities, staff concerns with medicines management and not responding promptly to the effects of unexpected changes in people's conditions or staffing levels.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring the service is well led.