16 September 2014
During an inspection in response to concerns
We carried out an early morning inspection and we spoke with the manager, four members of staff and three people who used the service.
The summary is based on our observations during the inspection, speaking with people using the service, and the staff supporting them and from looking at records.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
We looked at one person's care file relating to the concern that this person was being neglected. We had received information that staff were not supporting this person to eat appropriately and their weight was not being monitored. We referred these concerns to safeguarding. This person was still in bed at the time of inspection but staff we spoke with said they were eating really well at present. This persons care file evidenced that weight and the malnutrition universal screening tool (MUST) was being recorded weekly and the person had been referred to the dietician.
Is the service well-led?
Concerns were raised about the manager not supporting staff and night staff having to do extra work to make it easy for the day staff. This included getting people up very early, even if they did not want to get up.
We spoke with staff who all stated that the manager is very supportive. Night staff we spoke with said each person who used the service was different and had different needs. We observed that the majority of people stayed in their rooms or in bed for breakfast and that the day staff dealt with this.
Is the service effective?
Concerns were raised about the lack of food choice, the cook could not order any extra food and if a person who used the service had a biscuit this had to be written down. We observed the cook making breakfast and saw choice was offered. The cook said that they can order what extra food they need. We were also told it would be impossible to count biscuits as the people who used the service could help themselves if they wanted. We did not evidence this at the time of inspection due to people eating their breakfast. Two people who used the service who were up in the dining room were living with a dementia and unable to verify this.
Is the service caring?
People were supported by kind and attentive staff. We saw that staff asked people if they wanted to get up or have their breakfast in their room. We also observed people being offered a hot drink if they woke up early. We spoke with one person who used the service who was still in bed and stated that they liked to get up after breakfast.
Is the service responsive?
We observed night staff passing on information to day staff about the type of night they had experienced and peoples care needs. The member of staff on night duty suggested that three people who used the service needed to see a doctor that day. We observed the day staff arranging these appointments as soon as the surgery opened.
What people told us:
We spoke with three people who used the service, the manager and four members of staff. People who used the service said 'I really like it here, did not at first because I was sad to leave my home, I have been here three years now and have no problems at all.' 'I am offered choice with whatever I do.' and 'Staff are wonderful.'
Staff we spoke with said 'Everyone living here are different with different needs and we respect that.' 'We like to make sure we have time to sit with the residents and have a chat.' and 'My manager is really good and will support you whatever.'