Archived: Musmajas

When we inspected the home there were seven people living there. The home was arranged into four different sections. The main house was occupied by one person. The main house was also the area of the home where the offices and reception were located along with the kitchens and communal dining room and lounge. The home had three bungalows, each with several bedrooms and shared bathroom facilities. Each of the bungalows was occupied by people who used the service.

The manager told us the home was undergoing a planned refurbishment, which would be implemented as soon as the handover of services to the new provider was finalised. We saw the new provider had drawn up plans to redecorate areas of the home. Planned refurbishment work also included the updating of bedrooms in the bungalows to include en-suite facilities.

We spoke with two people who lived at Musmajas about their experiences of the service. We also spoke with three relatives of people who used the service about their family member's experience. We observed the care that was given to people during our inspection. We looked at care records at the home.

We spoke with a range of staff including two members of staff who provided personal care to people at Musmajas and the registered manager.

We visited the service to check on concerns that were raised at our previous inspection in November 2013 to see whether improvements had been made. We found further improvement was still required.

During our inspection we looked to see whether we could answer five key questions: Is the service safe, effective, caring, responsive and 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?

We observed staffing levels during our visit. We were concerned that there were no designated cleaning and laundry staff at the home, and care staff were asked to perform these tasks. We identified infection control issues during our inspection.

The home had policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLs). We saw no recent DoLs applications had been submitted. Relevant staff were trained to understand when an application should be made and how to submit one. The manager was aware of the latest guidance and information on DoLs and was planning a review of their procedures to ascertain whether any changes were required to their policy.

Systems were in place to make sure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistle-blowing and investigations. This reduced the risks to people and helped the service to improve.

Is the service effective?

People's health and care needs were assessed before they came to the home to determine their needs and make sure the service could meet them effectively. Specialist dietary, communication and equipment needs had been identified in care plans where required.

We saw arrangements were in place for care plans to be reviewed regularly to make sure information about people's care and support needs remained appropriate and accurate.

People had access to a range of health care professionals who visited the home when needed. On the day of our visit we saw the dentist was visiting the home to assess people's dental needs.

It was clear from our observations and from speaking with staff they had a good understanding of people's care and support needs and that they knew them well.

Is the service caring?

We saw staff were attentive to people's needs throughout our inspection. Staff interacted positively with people and staff gave people time to respond. We found staff showed patience when communicating with people who lived there.

People and relatives we spoke with were positive about the care staff provided. One person told us, "My relative is very settled there. I would not want anything to change. I'm more than happy."

Is the service responsive?

We saw people were able to access help and support from other health and social care professionals when necessary. One member of staff told us the doctor visited regularly to review the health requirements of people at the home.

We looked at how complaints had been dealt with at the service and found that an up to date complaints procedure was in place so that complaints could be investigated and dealt with in a timely way.

Is the service well-led?

The service had a quality assurance system in place to identify areas of improvement. We saw that there were recent audits in a number of areas including infection control. Records seen by us showed that identified improvements were addressed promptly. As a result the quality of the service was continuously improving.

People we spoke with told us that the care planning was discussed with them regularly. We saw that people were involved with the care planning of their care.

We found that staff listened to people about their care needs and their wishes. We saw people's independence was promoted within their care plans and on the day of our inspection.

We saw that the care plans were person centred and reflected people's individual needs. We noted staff were compassionate and caring when supporting people.

We noted the home was clean and the members of staff told us about their cleaning routine. We found that clinic waste bags were not used for transferring any soiled clothing. We saw there was no robust system in place on how mops were stored and used.

People we spoke with told us that staff were friendly and supported their needs well. We saw staff understood people's care needs and how they needed to be supported.

We found the service had systems in place to monitor the quality of service being provided.

We observed care staff supporting people with their daily routines and saw that people were not kept waiting to receive care and support. We joined people having their midday meal and saw that care staff offered people discreet assistance to eat and drink. One person told us, "If I ring the bell, the staff come to see what I need."

We spoke with care staff about their role in offering care and support to people and found their responses were consistent with the care plans and care records we looked at. One person commented, "The staff know me well and know how to help me."

People told us they had formed good relationships with the staff team. We were told, "I can have a laugh with the staff. That's really important to me."

We saw there were systems in place to review the quality of the service provided within the home and to seek people's views about the care and support they received.

We saw that staff had received regular opportunities to complete training to assist them to meet people's needs. One person told us, "I think the staff are very professional and friendly. They do a good job."