This inspection took place on 5 and 6 January 2016 and was unannounced. The home provides accommodation for up to 18 people, including some people living with dementia care needs. There were 17 people living at the home when we visited. The home was based on two floors; there was a good choice of communal spaces where people were able to socialise and some bedrooms had en-suite facilities.
There was a registered manager in place. 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.
People’s safety was compromised as the risks to their health and safety were not always managed appropriately and action had not always been taken to reduce the level of risk. This included the risks of one person choking on their food and the risk of two people having repeated falls. Accidents records were not organised and there was no process in place to identify trends.
Clear recruitment procedures were in place, but these were not always followed. Reference had not been obtained for a staff member who had recently been employed and full employment histories were not always obtained to check staff were suitable to work with the people they supported.
Staff sought consent from people before providing care. However, they had not protected one person’s rights as their freedom was being restricted and staff had made decisions on their behalf without following the relevant legislation.
Most people received personalised care from staff who understood and met their needs. Care plans provided detailed information about how they wished to receive care and support although some information in them had not been personalised to the individual. Records relating to continence care did not always contain sufficient information.
People were usually involved in planning the care and support they received, but this was not consistent and people were not involved in reviews of their care.
Effective systems were not in place to assess, monitor and improve aspects of the service, such as infection control, the management of falls and staff training. There was a Duty of Candour policy in place, but this was not always followed. The provider sought and acted on feedback from people, although the results of satisfaction surveys were not analysed or used to identify improvements.
People liked living at the home. Relatives felt it was run well and said they would recommend it to others. There were strong links with the community and the provider promoted a positive culture. Staff understood their roles, were motivated and worked well as a team.
People told us they felt safe. Staff had the knowledge and confidence to keep people safe through procedures they understood well. There were sufficient numbers of suitably trained and experienced staff to ensure people’s needs were met. New staff received induction, training and support from experienced members of staff. Staff felt supported by the provider and the registered manager, felt valued and said they were listened to.
People were treated with kindness and compassion and staff showed concern for people’s wellbeing. Their privacy was protected and staff treated them with dignity and respect.
Medicines were managed safely and people received their medicines when required. Risks posed by the environment were managed effectively and people were supported to take risks that helped them retain their independence.
People were offered varied and nutritious meals. They were given appropriate support when needed and their intake was monitored. People were supported to access healthcare services when needed to stay healthy and there were good working relations with healthcare professionals.
Staff responded to people’s change needs. People were empowered to make choices about how they lived their lives and had access to a range of activities.
We identified breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.