This inspection was carried out on 26 and 27 January 2016 and was unannounced.
Favorita House provides accommodation for up to 16 older people who need support with their personal care. Accommodation is arranged over two floors. A stair lift is available to assist people to get to the upper floor. The service has 12 single bedrooms and 2 double bedrooms, which people can choose to share. There were 11 people living at the service at the time of our inspection.
A registered manager was leading the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were treated with dignity and respect at all times. One person told us, “I am very happy here and would recommend the home to someone else. I’m satisfied with everything they are doing”.
The manager provided leadership to the staff and had oversight of the service. Staff were motivated and felt supported by the manager. The staff team had a clear vision of the aims of the service. Staff told us the manager was approachable and they were confident to raise any concerns they had with them.
There were enough staff, who knew people well, to meet their needs at all times. The needs of the people had been considered when deciding how many staff were required on each shift. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.
Effective staff recruitment systems were not in operation and information about the character and identity of staff had not been obtained to make sure staff did not pose a risk to people. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.
Staff were not consistently supported to provide good quality care and support. Staff had not completed all the training they needed to provide safe and effective care to people. Some staff held recognised qualifications in care. Staff met regularly with the manager to discuss their role and practice and any concerns they had.
Staff knew the signs of possible abuse and were confident to raise concerns they had with the manager or the local authority safeguarding team. Plans were in place to keep people safe in an emergency.
People’s needs had been assessed to identify the care they required. Care and support was planned with people and reviewed to keep people safe and support them to be as independent as possible.
People received the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were supported by staff to receive the care they needed to keep them as safe and well as possible.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Arrangements were in place to check if people were at risk of being deprived of their liberty and apply to the supervisory body for a DoLS authorisation when necessary.
Processes were not in operation to assess if people were able to make decisions but this did not impact on people using the service. Consent to care had been obtained from people. People were supported to make decisions and choices and decisions were made in their best interests if they were not able to do this. The requirements of the Mental Capacity Act 2005 (MCA) had been met. We have made a recommendation to improve practice in relation to this.
People were supported to participate in a wide variety of activities that they enjoyed. Possible risks to them had been identified and were managed to keep them as safe as possible, without restricting them.
People told us they liked the food at Favorita House. They were offered a balanced diet that met their individual needs. A wide range of foods were on offer to people each day and they were provided with frequent drinks to make sure they were hydrated.
People and their representatives were confident to raise concerns and complaints they had about the service with the manager and provider and had received a satisfactory response.
The manager and deputy worked with people and staff and checked that the quality of the care was to the standard they required. Any shortfalls found were addressed quickly to prevent them from happening again. People and their representatives were asked about their experiences of the care and these were used to improve the service.
Systems were not in place to check staff management processes such as training and recruitment and the provider was not aware of the shortfalls we found during the inspection. Following our inspection he provider took immediate action to put systems in place to check all areas of the service.
The environment was safe, clean and homely. Maintenance and refurbishment plans were in place. Appropriate equipment was provided to support the people to remain independent and keep them safe. Safety checks were completed regularly.
Accurate records were kept about the care and support people received and about the day to day running of the service. These provided staff with the information they needed to provide safe and consistent care to people.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
We made a recommendation to improve practice in relation to assessing people’s capacity to make decisions.