Archived: Praxis Care - 2 Norwood Drive

As part of this inspection we spoke with two people using the service, a relative and two staff as well as the registered manager. There were five people using the service when we visited. We observed staff interacting with people using the service and although we spoke with two people, only one was able to answer complex questions due to the nature of the service. We reviewed records relating to the safety and of the premises and management of the home which included care plans for four people, staff training records, staff rotas, safety inspections and quality audits.

Below is a summary of what we found. The summary describes what people using the service and their relatives, what we observed and the records that we looked at.

Is the service safe?

The manager told us that an assessment had taken place before people had gone to live at the home and was followed by comprehensive risk assessments after people had moved into the home. The premises were appropriate and safe: regular maintenance and safety inspections had taken place and recommendations or issues had been addressed promptly. Staff knew how to deal with emergency situations. The service used a high proportion of agency staff. This had been a long term issue but when we visited we found that the same agency staff worked at the home for long periods of time, were suitably trained and knew people's needs. Staff had been supported to receive appropriate training to care safely for the people using the service. CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No applications had needed to be submitted, but the manager understood how to do so and had been involved in discussions with the local authority team following recent changes to the law. Overall we found that the service was safe, although improvements to the permanent staffing arrangements was needed.

Is the service effective?

The service was effective. One person that we spoke with said that they received all the care and support that they needed at the home. A relative told us that their relative was cared for well but that there were not always enough staff to provide one to one support for them for them. They said that the staff were, 'Very good.' And that they, 'Do their best.'

It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. Staff told us that a person had become seriously unwell but had been supported through an effective plan of care and were now making a recovery. We saw evidence to support this. Care plans reflected assessed risks, were reviewed and updated appropriately. Staff understood capacity to consent issues. They talked about the ways that different people communicated and methods of helping them to understand information.

Is the service caring?

The service was caring. A relative said that the staff, 'Are caring and work very hard.' We spoke with the manager and staff who knew people's needs and spoke about people in a way that demonstrated that they cared about people's well-being. Staff told us how they tried to help people enjoy new activities that suited them. We observed staff interact with different people in a kind, patient and gentle way.

Is the service responsive?

The service was responsive to the changing needs of people using the service, to comments and suggestions and to recommendations made in reports about the safety of the premises. We saw assessments of people's needs resulted in care plans that staff read. The care plans helped staff to know the needs and care individual people required. Care plans were changed if people's needs changed. Plans were in place to ensure that agency staff got to know people and their needs before caring for them and that there was always a member of permanent staff on duty. A member of staff told us the manager was always responsive to new ideas such as new activities for people.

Is the service well led?

The service was led by a registered manager who we met. A member of staff said the manager was, 'Very supportive,' also they listened to staff concerns, were visible and knew the people using the service well. They said the manager always spent time with all of the people using the service every day, talking to each individually. The service had a system in place to monitor and assess the quality of the service. The manager was supported by the provider's Assistant Director who visited the service and audited care files in order to act to improve quality and safety at the home. The manager told us they had tried to ensure that people received a good quality service despite problems recruiting new staff. Staff were supported to complete a comprehensive induction program and on-going training to meet the needs of people living at the home.

The manager told us that a new provider was about to take over the service and a relative confirmed that they had been involved in the process of this change.

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

We spoke to two staff, they told us: 'My role is to support people make choices, I have got to know people, and although people cannot always tell me what they need, you can tell by their behaviour.' 'I have known the people living here along time, I am a face that people recognise, and you get to know people's ups and downs, likes and dislikes.'

We observed staff preparing drinks for people throughout the day, supporting and encouraging people to drink. People were provided with a choice of suitable and nutritious food and drink.

The home was well maintained, clean and tidy. We looked at the kitchen, toilets and shower areas and one person allowed us to look into their room. We found all areas to be clean and fresh.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. This included bimonthly meetings with people living in the home and meetings with relatives and carers.

The two care records we looked at were comprehensive and provided a clear assessment of the person's need. The care plans were detailed and included person centred care, which showed how people would like to see their needs being met.

We saw that in one care record an individual had expressed an interest in a football team and cars. We observed, in their room, a wide range of items relating to their interests, and throughout the day we observed staff talking with them about their interests.

One person living in the home told us: 'Staff are nice, I like cooking, they help me to cook. I have a five a day star chart now.'

One person's relative told us: 'They talk to me and ask me before anything happens. I get involved with everything.'

The building is purpose-built, on one level, with open access to the kitchen area and two communal rooms. People have their own rooms.

One relative told us: 'It is so much better for X when everything is on the same level.'

There were enough qualified, skilled and experienced staff to meet people's needs.