Carisbrooke

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated good

The service continues to keep people safe. Robust recruitment and deployment ensures that sufficient staff are employed to support people and help keep them safe. Detailed risk assessments continue to consider least restrictive options to enable people to continue engaging in activities that they enjoy.

Medicine management continued to be provided in a safe way, with audits illustrating that people received their medicines in a timely way and how they wished.

Staff continued to be supported to provide the most effective care to people. Their training was kept up to date, and they were provided appropriate supervisions and appraisals to ensure their practice was assessed.

People's needs were assessed initially upon admission, and thereafter reviewed monthly to ensure care was the most apt. People were encouraged to personalise their rooms in a style that they preferred.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff approach remained caring. People were supported by a staff team that knew them well, and ensured they enabled them to maintain their independence. Where support was required, people's dignity and privacy was maintained. People communicated in their preferred way, with records clearly highlighting this.

The service continued to ensure person centred care was delivered by staff. Care plans were written for people, detailing how they wished to be supported. Activities, both in-house and external were responsive to people's preferences.

The service continued to be well-led. There was a clear vision and direction from the registered manager. An open-door policy was practiced, whereby staff were able to approach the manager and discuss issues.

Good community links were created, and the service worked efficiently with other professionals. The service continued to have good governance and reflective practice, with compliance of the regulations.

Further information is in the detailed findings within the report.

The home is required to have a registered manager. The manager has been in post since May 2014, and has completed registration with the 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.

Staff knew how to keep people safe by reporting concerns promptly through a procedure which was displayed in the office. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. There were sufficient numbers of suitably trained and experienced staff to ensure people’s needs were met.

We observed good caring practice by the staff. Relatives of people using the service said they were very happy with the support and care provided. People and where appropriate their relatives confirmed they were involved in the planning and review of their care. Care plans focussed on the individual and recorded their personal preferences well. They reflected people’s needs, and detailed risks that were specific to the person, with guidance on how to manage them effectively.

People told us communication with the service was good and they felt listened to, with regular team meetings being offered. All relatives spoken with said they thought people were treated with respect, and staff preserved their dignity at all times.

People were supported with their medicines by suitably trained, qualified and experienced staff. Medicines were managed safely and securely. Protocols for PRN (as required medicines) were detailed providing guidelines on when these should be given. Staff were able to verbally describe the protocol, and the Medication Administration Record (MAR) sheets did not suggest disproportionate usage.

People who could not make specific decisions for themselves had their legal rights protected. People’s care plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The DoLS provide legal protection for vulnerable people who are, or may become, deprived of their liberty.

People received care and support from staff who had the appropriate skills and knowledge to care for them. All staff received comprehensive induction, training and support from experienced members of staff. They felt supported by the registered manager and said they were listened to if they raised concerns.

The quality of the service was monitored regularly by the provider, as well as by an externally commissioned auditor. A thorough quality assurance audit was completed quarterly with an action plan being generated, and followed up on during identified timescales. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service.

Some of the people who use the service had complex learning disabilities and were not able to speak to us. Some people were able to speak with us and we spoke with two people who use the service. One person told us the home was the "best ever place I've lived". Another indicated they were happy living at the home. We spoke with two relatives of people who use the service. One told us they had been "very impressed" with the care their relative received. Another told us "I am very happy. XX appears settled and happy"

Care was planned to meet people's needs and was regularly reviewed to reflect any changes to people's needs. We observed the support people received reflected the assessments. People and their relatives were involved in planning their care.

There were arrangements in place to protect people from the risk of abuse. Staff had received training and were clear in understanding their responsibilities.

We found the provider had effective systems in place for monitoring the quality of the service. This included obtaining the views of the people who used the service.

Staff were able to describe how they sought consent from people who use the service, whether by speaking with the person, or by observing people’s behaviours where they were not able to communicate verbally. The provider did not always consider people's capacity to consent in line with the Mental Capacity Act 2005.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Staff were knowledgeable about people's care requirements. Relatives we spoke with told us they were involved in people’s care planning. One person told us the care their relative received was “very good” and when speaking about the staff said “I want to praise them in every department”. Another said “they are very sensitive and gentle”.

We saw the home was clean, and staff were knowledgeable about infection prevention and control. A relative told us their relative’s room was “always clean”.

The provider had systems in place to deal with comments and complaints and information about complaints was provided in a format that met people's needs. However, inaccurate information was provided to people on how to escalate complaints outside of the organisation if they needed to.