Archived: Herondale

During our previous inspection in November 2013 we had found that the provider was not meeting all of the regulations that we inspected. During this inspection we looked to see if improvement had been made and found that it had.

We spoke with the registered manager, deputy manager and with seven staff on duty. We spoke with two people that lived there and six people's relatives. We saw that most people that lived there had difficulty in verbally communicating their thoughts so we spent time observing them and their interactions with staff to help us understand their experience of care.

Our conversations with people helped us to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? and, Is the service well led?

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

Both people that we spoke with told us that they felt safe at the home. One person told us, 'The staff look after you here.'

All of the relatives that we spoke with told us that they believed their family member was safe at the home.

There was a system in place to record accidents and incidents. Staff spoken with showed that they were aware of the reporting system. We saw that the provider looked at any accidents that occurred so that appropriate action to reduce the risk of the reoccurrence of accidents or incidents.

There was a system in place to handle concerns and complaints. One relative told us, 'I've no complaints.' All of the relatives spoken with told us they would discuss any concerns with staff if they had any.

As part of our inspection we asked the provider about how they implemented the Mental Capacity Act 2005. We saw that the provider's general mental capacity assessment record had been completed. We also saw that some people had 'best interest' agreements in place. These included, for example, a 'best interest' agreement that some people's medication could be administered to them in a disguised way so that their physical and mental health wellbeing needs were treated. The registered manager told us that they in the process of making further referrals for people that lived there as required.

We saw that referrals for some people had been made when needed under the Deprivation of Liberty Safeguards. The registered manager told us that they in the process of making further referrals for people that lived there as required. This meant that the registered manager was aware of their responsibilities under the Mental Capacity Act and the Deprivation of Liberty Safeguards.

Is the service effective?

We found that people's health, care and support needs were assessed and that people had care plans in place.

All of the staff spoken with demonstrated that they were aware of people's identified needs and how people should be supported to meet these. We observed positive interactions between staff and people.

We saw that activities were planned for and took place. We observed a Church service that took place. We also saw that people could enjoy the enclosed garden. However, we saw that some people may benefit from rummage boxes and things that they could hold that would be meaningful to them.

Is the service caring?

Most people that lived there had difficulty in verbally communicating their thoughts so we spent time observing them and their interactions with staff. We observed positive interactions. Staff were respectful and spoke to people kindly. Staff had a patient and calm approach to people.

Most staff that we spoke with had worked at the home for a number of years and knew the care support needs of people well. One staff member told us, 'I've worked here years. I love my job, helping the people that live here.'

Is the service responsive?

We spoke with two people that lived there and they told us that they felt the service met their needs. One person told us, 'The staff are friendly here. I have choices about meals and what time I go to bed. I can more or less please myself what I do.' Another person told us, 'I am happy here.'

Is the service well led?

The service had a registered manager in post. There were clear management structures in place offering support and leadership.

All of the staff spoken with told us that they felt supported in their job roles by both the registered manager and deputy manager.

The provider had a quality assurance system in place. The registered manager told us that some checks, such as staff spot checks and daily logs, were completed informally and not documented. They told us that they planned to build upon their quality assurance systems and would document their checks, such as their audit on daily logs. We looked at some documented audits such as a medication check and saw that these were effective.

Relatives told us that they were asked for feedback about the quality of the service provided.

We found that people were supported with personal care each day. There were written records about the care and support people needed but these had not always been completed for all people's assessed needs. People had access to activities but relatives felt these needed to be increased.

We found there were some systems to safeguard people from abuse. We did not find that abuse was always recognised or reported and that records about challenging situations were not maintained.

The records showed adequate numbers of staff were on duty, but health professionals and relatives did not always perceive these numbers were adequate. We did not find that staff were on duty at the correct time in the morning to ensure people got breakfast at a reasonable time.

We found there were systems in place to review the service offered and develop it further to meet people's needs.

We spoke with the relatives of five people who used the service. The relatives we spoke with were satisfied with the care provided at the home. They told us 'It's absolutely lovely and all the staff are brilliant'; 'They (the staff) are good. Never found anything wrong' and 'I find the carers very kind.'

There were enough staff with relevant experience to meet the needs of people using the service. We observed people being calmly supported to ensure their care needs were met including peoples nutritional needs. Equipment in use at the home was regularly serviced and maintained.