During our inspection we spoke with six people who used the service. We also spoke with the new manager, deputy manager, visiting quality manager for the provider and five staff. We inspected people's care records, staff training and supervision records and documents relating to the quality of the service and health and safety checks undertaken by the provider. Below is a summary of what we found.
During our inspection we looked to see whether we could answer five key questions: is the service safe, effective, caring, responsive and well led?
Is the service safe?
The provider had effective safeguarding procedures in place to protect people from the risk of abuse or harm.
We looked to see whether there were the right levels of staff working at the service. There were sufficient staff to meet people's needs.
We found that the service did not have suitable arrangements in place to gain people's consent and assess their mental capacity to make decisions before acting on their behalf. Staff did not always understand their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
The service had a safe medication administration system in place. People received their medications on time and staff were trained to support people safely.
The service had a robust recruitment process in place which meant that they checked and ensured that staff were fit and safe to work with vulnerable people.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents. This reduced the risks to people and helped the service to improve.
Is the service effective?
People's health and care needs were assessed before they came to the home to determine their needs and make sure the service could meet them effectively. Care plans seen included information about the care and support provided to people such as support with their personal care needs, mobility, behaviour and medication.
We saw arrangements were in place for care plans to be reviewed regularly to make sure information about people's care and support needs remained appropriate and accurate. There was no evidence that people had been involved in the review of their care.
We had concerns about the staff employed to work at the service and the update of their skills to support the people who used the service. We had concerns about the information and subjects covered in a recent refresher course staff had undertaken. This meant that we could not be assured that staff had the necessary skills to support people effectively.
Is the service caring?
We saw staff were attentive to people's needs throughout our inspection. Staff interacted positively with people and gave people time to respond. We found staff showed patience when communicating with people who used the service.
People told us that the staff were caring. One person said about the service, 'I like it here, I don't have to do anything, feel lazy sometimes.' Another said about staff, 'The staff are always very busy, but they are all very kind.'
Is the service responsive?
We saw people were able to access help and support from other health and social care professionals when necessary.
Although some activities took place at the time of our inspection there were no evidence in any of the recent records we saw that showed how people were involved and engaged within the service or assisted to access the community.
The service responded well to concerns about the safety of people who used the service. A visiting relative told us that the service always responded to any issues and addressed these.
People told us that the service responded to their needs. One person told us, 'They (staff) are very good too, very kind.' Another person told us, 'I do most things myself but if I need help they (staff) help me.'
Is the service well-led?
The service had a quality assurance system in place to identify areas of improvement. There were regular audits on medication and the environment.
Records seen by us showed that identified repairs and maintenance were addressed promptly. As a result the quality of the service was continuously improving.
The staff members we spoke with told us that since the new manager had started things had improved and they felt well supported and able to access the manager for support. However there had been no recent formal arrangements in place for supervision or appraisal which meant that we could not be assured that staff were receiving appropriate professional development and support.