This inspection took place on 19 February 2015 and was unannounced. We previously visited the service on 19 September 2014 and made three compliance actions in respect of shortfalls identified. These included: concerns about staffing levels, the lack of an emergency contingency plan, gaps in staff training, insufficient recording on food and fluid charts and the lack of an effective quality assurance system. We received an action plan from the provider stating they would be compliant with these identified shortfalls by 31 December 2014.
The service is registered to provide accommodation, personal care and nursing care for a maximum of 55 people, some of whom are living with a dementia type illness. On the day of the inspection there were 49 people living at the home. Most people are accommodated in single rooms with en-suite facilities. The home is in Beverley, a town in the East Riding of Yorkshire. It is close to local amenities and has a car park.
The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager in post who was not yet registered with the Care Quality Commission (CQC). 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. The manager told us that she intended to apply for registration very soon.
People told us that they felt safe living at the home. Staff had completed training on safeguarding adults from abuse and were able to describe to us the action they would take if they had concerns about someone’s safety. They said that they were confident all staff would recognise and report any incidents or allegations of abuse.
The arrangements for ordering and storing medication were robust and medicines were administered safely by staff who had received appropriate training.
The manager was aware of good practice guidance in respect of supporting people living with a dementia type illness and had introduced signage in the home to assist people with orientation.
We observed good interactions between people who lived at the home and staff on the day of the inspection. People told us that staff were caring and compassionate and this was supported by the relatives and health / social care professionals who we spoke with. People also told us that staff were effective and skilled. Staff told us that they were happy with the training and support provided for them.
People were supported to make their own decisions and when they were not able to do so, meetings were held to ensure that decisions were made in the person’s best interests. If it was considered that people were being deprived of their liberty, the correct documentation was in place to confirm this had been authorised.
We saw that there were sufficient numbers of staff on duty to meet the needs of people who lived at the home. New staff had been employed in line with the home’s recruitment and selection policies to ensure that only people considered suitable to work with vulnerable people had been employed.
People’s nutritional needs had been assessed and people told us that they were satisfied with the meals provided by the home. People were supported appropriately by staff to eat and drink safely and their special diets were catered for.
There were systems in place to seek feedback from people who lived at the home, relatives, health and social care professionals and staff. People’s comments and complaints were responded to appropriately.
People who lived at the home, relatives and staff told us that the home was well managed. The quality audits undertaken by the manager were designed to identify any areas of concern or areas that were unsafe, and there were systems in place to ensure that lessons were learned from any issues identified.