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We are carrying out a review of quality at Fouracres Care Services. We will publish a report when our review is complete. Find out more about our inspection reports.
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Inspection report

Date of Inspection: 2 May 2014
Date of Publication: 5 June 2014
Inspection Report published 05 June 2014 PDF | 77.07 KB

Overview

Inspection carried out on 2 May 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Our inspection of 27 January 2014 found that people were at risk as there were not enough staff available to meet their needs and respond in the event of an emergency to maintain their safety. On the day of our inspection one person was using the service. We saw that the person received one to one care from a member of staff. The rota showed that the manager and two members of staff were on duty throughout the day. Risk assessments were in place to ensure that person's safety and well-being was maintained when receiving care. Risk assessments provided guidance for staff on how to minimise risks to people.

The person's records including their care plans were accurate, and had been reviewed and updated at regular intervals. Care records gave an explanation of how the person's needs were to be met. This meant that care records supported staff to provide safe and appropriate care to the person who used the service. Personal records including medical records were accurate and fit for purpose.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

Our inspection of 27 January 2014 found that staff had not completed all the relevant training they needed to meet people's needs safely, and the provider did not have a training matrix that showed when staff would receive this training. At this inspection we found that a training matrix outlining what training was needed had been put in place.

Staff received appropriate professional development. We spoke with one member of staff who told us they had recently received training in challenging behaviour, epilepsy, first aid, and breakaway and restraint techniques. We looked at the training records for three staff and saw that they all had received this training recently. Staff understood how to apply what they had learnt to their work with the person who used the service.

We looked at the care plan for the person who used the service. This provided information about the person’s needs and gave guidance for staff about how they should be met. People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others. The records of the person using the service showed that they were supported to have regular health checks with their general practitioner, psychiatrist and other care professionals.

Is the service caring?

We observed that the person’s changing behaviour was responded to sensitively in a manner that enhanced their well-being. Where necessary the appropriate professionals had been consulted for advice regarding person’s behaviour. Staff explained that the person using the service often found it difficult to go to the surgery or to hospital appointments as this made them anxious. Staff told us that they had spent time taking the person to the surgery and the hospital so that they overcame their anxieties about seeing health professionals. This was documented in their care plan and the care plan gave staff guidance on how they were to respond to the person's anxieties when accessing healthcare. This meant that the person was supported to meet their health needs in a way that maintained their well-being.

Is the service responsive?

Care plans identified the person's needs resulting from their cultural background. Daily notes showed that the person who used the service had taken part in activities and were supported to access their local community. For example, the person was supported to go to the park and to do their shopping.

Staff knew how the person communicated and responded to the person’s requests. The person’s views were recorded in one-to-one meetings, and when their care plan was reviewed. Staff explained that regular key worker discussions were used to help the person to be involved in decisions about their care. Staff listened to people and acted on their views.

Is the service well-led?

People who used the service, their representatives and staff were asked for their views about their care and treatment and these were acted on. An annual quality survey had been carried out. The manager explained that a report had been produced, and any suggestions to improve the service were addressed. Peoples' suggestions were used as the basis to improve the care provided by the home.

Staff told us they were able to make suggestions to improve the home. Staff said the manager was supportive. They felt that staff meetings provided them with a way to raise issues. Staff were supported by the manager to take an active role in improving the care of people.