Archived: Masson House

There was a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission 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. At our last inspection in January 2014 the provider was fully compliant in all areas inspected.

Records we looked at were very poorly maintained and updated. Care plans had not been updated they were not personalised and did not always included decisions people had made about their care including their likes, dislikes and personal preferences.

Staff were appropriately trained and confident to meet the basic needs of people they cared for. However staff did not have access to additional training specific to the needs of people using the service, such as palliative care, dementia awareness and falls management.

The service was not managed in an inclusive manner. The registered manager managed in a closed and exclusive manner that did not allow staff to make informed decisions on people’s health and welfare. Staff were not always fully aware of their roles and responsibilities for people’s care. The registered manager did not have effective systems in place to review the service and to ensure the service responded to the current needs of people.

During our inspection we observed staff delivering care which met people’s individual needs and which supported them in a respectful and appropriate way. There was not always adequate training and processes in place to keep people safe and staff generally followed these. People’s physical health was promoted although staff needed more specialist training to effectively support people with mental health care needs. Medicines were stored appropriately and they were administered and recorded as prescribed.

Visitors were welcomed to the service at all reasonable times. There was a complaints process in place and the service received may complements.

Most of the staff had some understanding and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards.

We saw staff ensured people were comfortable and had something of their choice to occupy them. We saw people were supported in a relaxed and unhurried manner. Staff were caring and communicated well with people.

Staff focused on people they were caring for rather that the task they were carrying out. Staff spoke in a positive manner about the people they cared for and had taken the time to get to know people’s preferences and wishes. Staff had a good understanding of people’s needs and this was demonstrated in their responses to people and recognition of when people required additional support.

People’s privacy was respected. People had their independence promoted. They were offered choice on how they wanted their care delivered and were given choices throughout the day. The service endeavoured to provide end of life care so people had a choice about where they spent the end of their life. Relatives were offered the opportunity to stay with their relative at this time.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration Requirements) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

We found that people experienced care and support that met their needs and protected their rights and that their medicines were mostly safely managed. People were asked for their consent to their care before it was given and where people could not consent we found the provider acted in accordance with legal requirements.

People told us that the home was mostly kept clean, tidy and hygienic and we found that the provider had made some improvements in their arrangements for the prevention and control of infection in home since our last inspection. However, we found people were not fully protected from the risks of infection and or by the provider's staff recruitment and selection procedures.

The people we spoke with said that staff talked things over with them before carrying out their care and asked for their consent before decisions regarding their treatment. Staff respected people's personal preferences and people thought that their needs were being met. One person told us, 'I like chess, television and discussing current affairs with staff.' Care plans were clearly centred on people's particular, individual needs.

People told us that the premises were kept clean. However, there was a lack of systems in place to reduce the risk and spread of infection.

People thought that staff were well trained to meet their needs and records confirmed that that most staff were up to date with relevant training.

The views of people who use the service were being sought through satisfaction questionnaires. People told us they felt listened to: one person said, 'If there's anything I'd like to bring up I could talk to my key worker ' I feel confident.'