Archived: Minsden

We identified shortfalls in relation to the levels of respect, involvement, care and welfare experienced by people who lived at the home. We also found that there had been insufficient numbers of staff, inadequate levels of support provided to staff and shortfalls in the assessment of risks and service provision.

We told the provider to make improvements and subsequently received action plans which stated that the home would be compliant with the regulations by 15 November 2013. During our inspection carried out on 14 January 2014, we found that necessary improvements had been made.

We saw that staff treated people who lived at the home with respect and dignity. We looked at records which showed that people had been involved in the planning and delivery of care that met their needs. One person told us, 'The staff are very helpful. I get the levels of care and support that I have discussed and agreed to. I get very well looked after here.'

The provider had taken appropriate steps to ensure that there were sufficient numbers of staff available at all times to meet people's needs. We saw in records that staff had been appropriately trained and supported to perform their roles. One member of staff told us, 'It's so much better now. We have a strong care home manager who has set high standards and supported us to turn things around.'

We saw that systems had been introduced to assess the quality of service provision and to manage risks.

We found examples of where people's privacy and dignity had not been respected and where they had not been involved in decisions made about their care. One person told us, 'They don't always knock on the door and ask to come in. Some do but some don't.'

Care plans we looked at showed that people's needs and preferences had been assessed, documented and reviewed. However, people expressed mixed views about the levels of care provided. One person said, 'I don't mind it here'.I get well looked after. I'm fairly happy here.' Another told us, 'Overall I don't feel well looked after'.

We saw that arrangements were in place to ensure staff had been properly trained to carry out their roles. One person told us, 'I think they [staff] are very good. I'm impressed from a personal view point.' However, most staff we spoke with told us they had not been adequately supported by the provider.

We found there had not always been enough staff on duty to meet people's needs. A member of staff told us, '[The] pressure is great here; too few staff doing too much work. We try our best to look after people and make them comfortable.'

Records we looked at showed that effective systems had not been put in place to manage risks or monitor the quality of services provided.

However, suitable arrangements were not in place where necessary to properly assess people's ability to make decisions in line with published guidance relating to the Mental Capacity Act 2005.

Care plans we looked at showed that people's needs and preferences were assessed when they began to use the service. They contained clear guidance to staff about how to deliver care that met people's individual needs and requirements. One person said, 'They are so kind to me and I feel safe. I feel at home, I really do.'

The checks we made, and records we looked at, showed that appropriate arrangements were in place to ensure medicines were stored, handled and administered safely.

Records showed that effective recruitment procedures were in place to ensure that staff were fit, able and properly trained to meet the needs of people who used the service.This included carrying out appropriate checks before staff began work.

The provider had an effective complaints procedure in place. Records we looked at showed that people's complaints were taken seriously and fully investigated. Everyone we spoke with knew how to complain and to whom, but told us they had no reason to do so.