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Inspection report

Date of Inspection: 7 November 2013
Date of Publication: 3 December 2013
Inspection Report published 03 December 2013 PDF | 78.05 KB

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We carried out a visit on 7 November 2013, observed how people were being cared for, checked how people were cared for at each stage of their treatment and care and talked with people who use the service. We talked with staff and reviewed information sent to us by commissioners of services.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

Everyone who lived at the home shared the same faith. We saw that people were supported to maintain their beliefs and practices. People we spoke with told us they had regular bible readings. Just before lunch, we saw that staff read aloud from the bible to people who lived at the home, because this was a custom of their faith. We found that members of the church regularly visited to check that people were happy with their care and support. On the day of our inspection, two members of the church came to encourage people to take part in some physical exercise. We saw that people enjoyed this activity and took part enthusiastically. This meant that people were supported to maintain their links with the community.

In the two care plans we looked at, we found that people’s needs were assessed before they moved into the home. The manager told us they visited people in their own homes to discuss their needs and abilities. We saw that the manager identified risks to people’s health and well-being. The manager assessed risks to people’s mobility, nutrition and skin condition, for example. People’s care was planned to minimise their identified risks.

People’s care plans explained why and how people needed care and support to maintain as much independence as possible. Care staff we spoke with told us the care plans were useful to get to know people. A member of care staff told us, “I read the care plans right at the beginning, when people move in."

People’s care plans were translated into daily instructions for staff. During the handover between shifts, we heard that care staff were allocated to support named individuals for each shift. Care staff told us they appreciated this, because they were able to focus on individual people’s needs. We saw that staff signed the daily instructions so senior staff knew who supported each person with specific aspects of their care. This meant that people’s needs were assessed and care and treatment were planned and delivered in line with their individual care plan.

We found that staff shared information about how people were in daily records and during the shift handover. Care staff we spoke with told us, “We share information with the senior, if a person is unwell for example” and “At handover we are told how people are, how they have been” and “There is a night care book so we know if people have a good night’s sleep or not."

Records we looked at showed that senior staff asked other health professionals to visit when they were concerned about a person’s health. In one record we looked at, we saw that staff had asked a dietician’s advice when the person was not eating well. Records showed that staff had followed the dietician’s advice and the person had begun to gain weight.

The provider might like to note, that the person’s weight was recorded in three different places, sometimes in stone and pounds and sometimes in kilograms. The manager agreed that this had caused some confusion about how much weight the person had gained and whether they were currently at a safe weight for their height and frame. The manager told us that, although the dietician was satisfied that the person was regaining weight, they would continue to record the amount of food and fluid the person consumed, until they regained their initial weight. The manager said they would make sure that staff recorded people's weight in the same place and format for everyone in future.

We saw that people’s care plans were regularly reviewed by senior staff. When people’s abilities changed, their care plans were changed. One care plan we looked at showed that when the person’s ability to mobilise had deteriorated, their care plan was updated to make sure the appropriate equipment was in place. Care staff told us that this person now needed support from two staff working together to keep them safe. This meant that care and support were planned and delivered in a way that ensured people’s safety and welfare.