24 August 2016
During a routine inspection
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager is always a joint registered provider.
One person said; “I feel safe with the staff.” Staff said; “We help people stay safe and well by protecting them, for example providing protectors in case they fall.” Professionals spoken with all felt people were safe living in the service.
People were engaged in different activities and enjoyed the company of the staff. There was a calm and relaxed atmosphere within the service. One person said; “I go out to a day centre and really enjoy it.” People said they were happy living at the service.
People were happy with the care the staff provided. They agreed staff had the skills and knowledge to meet people’s needs. People were encouraged and supported to make decisions and choices whenever possible in their day to day lives.
People were protected from harm as staff had completed safeguarding of vulnerable adults training. Staff had the knowledge on how to report any concerns and what action they would take to protect people. The registered manager worked in the service most days and had taken action where they thought people’s freedom was being restricted. Applications were made and advice sought to help safeguard people and respect their human rights.
People who did not have capacity to make decisions for themselves were supported by staff to make sure their legal rights were protected. Staff worked with other professionals in people’s best interests.
People were protected by safe recruitment procedures. Staff were supported with an induction and ongoing training programme to develop their skills, and staff competency was assessed. People said there were sufficient staff on duty.
People had their privacy and dignity maintained. Staff were observed supporting people with patience and kindness.
People had visits from healthcare professionals. For example, GPs and occupational therapists, to ensure they received appropriate care and treatment to meet their healthcare needs. Professionals confirmed staff followed the guidance they provided. People received the care they needed to remain safe and well. For example, people had regular visits by district nurses to change dressings. People’s end of life wishes were documented and respected.
People’s medicines were managed safely. Medicines were stored, and disposed of safely. Senior staff administered medicines, they confirmed they had received training and understood the importance of safe administration and management of medicines.
People were supported to maintain a healthy balanced diet. People told us they enjoyed their meals and there was plenty of food available. We observed people, who required it, being supported at mealtimes. One person said; “Food is generally very good.” People’s care records were of a good standard, were detailed and recorded people’s preferences.
People’s risks were considered, well-managed and regularly reviewed to keep people safe. Where possible, people had choice and control over their lives and were supported to engage in activities. Records were updated to reflect people’s changing needs. People and their families were involved in the planning of their care.
People and staff described the registered manager and registered provider as “approachable”, “available” and “supportive”. Staff talked positively about their jobs and took pride in their work. Visiting professionals and staff confirmed the registered manager and registered provider made themselves available and were very good at supporting them.
The registered manager and registered provider had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.
People’s opinions were sought formally and informally. There were quality assurance systems in place. Feedback was sought from people and their relatives to assess the quality of the service provided. Audits were conducted to ensure the quality of care and environmental issues were identified promptly. Accidents and safeguarding concerns were investigated and where there were areas for improvement, these were shared for learning.