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Inspection report

Date of Inspection: 20 May 2014
Date of Publication: 6 June 2014
Inspection Report published 06 June 2014 PDF | 92.34 KB

Overview

Inspection carried out on 20 May 2014

During a routine inspection

Prior to our inspection we received some anonymous information. We considered this information and brought forward our scheduled inspection.

We spoke with five people using the service, one visitor, a district nurse and the local authority. We also spoke with three care staff, the cook and a kitchen assistant, the registered manager, the compliance manager and the owner. We viewed records which included, three care plans, daily care records, staff duty rotas, menus and records of meals served, monitoring records and equipment service records.

We considered the evidence we had gathered under the outcomes we inspected and were satisfied with the evidence provided in relation to the concerns. We used the information to answer the five questions we always ask:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found:

Is the service safe?

There were policies and procedures in place relating to the Mental Capacity Act and Deprivation of Liberty Safeguards. The manager confirmed no applications had been submitted since our last inspection.

We found all areas of the home to be bright, safe and comfortable. People had access to a range of appropriate equipment to safely meet their needs and to promote their independence and comfort.

During our visit we observed staff responding promptly to people’s requests for assistance. However, following our discussions with people, we were concerned staff were not always freely available to meet people’s needs. We shared our concerns with the manager and the owner and care staff numbers were immediately reviewed and increased. This meant there were sufficient numbers of staff to meet people’s needs at all times.

Is the service effective?

Everyone we spoke with told us they enjoyed the meals. One person said, "The food is fantastic; there is always a choice". A visitor said, “Mum always gets enough to eat; the food is very good and there is always a choice”. Staff were aware of people's dietary preferences and were able to provide specialist diets as needed.

People told us they enjoyed the activities both inside and outside the home. Activities were arranged for small groups of people or on a one to one basis.

Regular reviews were carried out to respond to any changes in people's needs and to ensure the level of care was appropriate. We noted the records did not clearly show people's involvement in this process. However, people told us they were involved in discussions about their care and kept up to date with any changes.

Is the service caring?

People told us they were happy with the care and support they received. Comments included, “I am 100% satisfied; the care is second to none”, “Moving here was the best thing I ever did” and “I am very happy here”.

Care records contained useful information about people's preferred routines and likes and dislikes which would help ensure people received the care and support they needed and wanted.

Staff were observed interacting with people in a kind, pleasant and friendly manner and being respectful of people's choices and opinions. People told us, "Staff are lovely”, “Everyone is very nice to me” and “I feel confident to leave mum in their care”.

Is the service responsive?

People's health and well-being was monitored and appropriate advice and support had been sought in response to changes in their condition.

The service had good links with other health care professionals to make sure people living in the home received prompt, co-ordinated and effective care. A district nurse told us staff notified them of any issues relating to their 'patient's' health and well-being and that any instructions they gave were followed.

Is the service well-led?

The manager had recently been registered with the Care Quality Commission (CQC). We received positive feedback about the manager. One person living in the home said, "The manager is lovely; she asks if I am alright”. Staff told us, “The manager is approachable and sorts things out; she is very hands on and works with us so she knows the residents”.

People were encouraged to express their views and opinions of the service during day to day discussions with staff and management and through annual customer satisfaction surveys (October 2013). However, we were told residents and relatives meetings had not been held. People should be kept up to date and involved with any decisions about how the service was run.

There were systems in place to assess and monitor how the home was managed and to monitor the quality of the service; this included regular visits by the ‘owner’. However, a number of the ‘checks’ were not formally recorded which meant it was difficult to determine how effective the systems were. We were told regular monitoring visits were being introduced which should help protect people from poor care standards and identify any areas of non-compliance.