Background to this inspection
Updated
12 April 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection visit took place on 22 February 2017 and was unannounced. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information we had received from the public. We also received feedback from the local authority who provided us with current monitoring information. We used this information to formulate our inspection plan.
We also had a provider information return (PIR) sent to us. A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. As part of our planning, we reviewed the information in the PIR.
We spoke with 10 people who used the service, five relatives and a visiting community professional. We also spoke with four members of care staff, the cook, the deputy manager and the manager. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas.
We looked at the care plans of five people to see if they were accurate and up to date. We reviewed one staff file to see how staff were recruited and checked the training records to see how staff were trained and supported to deliver care appropriate to meet each person’s needs. We also looked at records that related to the management of the service. This included the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.
Updated
12 April 2017
This inspection was unannounced and took place on 22 February 2017. The service was registered to provide accommodation for up to 27 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection, 19 people were using the service.
The service did not have a registered manager. 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. The provider had recruited a manager who had been working at the service since January 2017. They told us they were in the process of applying to register with us.
At our last inspection on 10 February 2016, we issued requirement notices in relation to reducing environmental risks for people and the need for consent. The provider sent us an action plan on 12 April 2016 that told us about the improvements they would make. At this inspection, we found that some improvements had been made, but further actions were required.
The provider had made improvements within the home that meant people who used the service were no longer at risk from the environment they lived in. However, we found that the provider could not ensure that people’s medicines were managed in a safe and proper manner.
We had also told the provider to ensure that when people were not able to make decisions for themselves, this had been assessed and decisions made in people’s best interests were evidenced. These required improvements had not been made. However, when people who lacked capacity were being restricted, the applications to ensure this was being done legally had been submitted.
People were safe and protected from harm by staff who understood how to recognise signs of abuse and knew how to report concerns. Risks to people were assessed, managed and reviewed. The environment had been improved so risks associated with this were minimised. There were enough staff to meet people’s needs and keep them safe and there were safe recruitment processes in place.
Staff received an induction and training to give them the knowledge needed to carry out their roles. People enjoyed their food and were supported to maintain a balanced diet. They were able to access healthcare services when needed and changes in people’s health were responded to.
People were supported by staff who were kind and compassionate. Positive relationships had been developed and staff knew people well. People’s independence was promoted and they were enabled to make day to day decisions about their care. People’s privacy was respected and staff treated people in a dignified way. Visitors were made welcome and people were able to maintain relationships that were important to them.
People were involved in the planning of their support, and the care they received was individual to them. There were opportunities for people to take part in activities they enjoyed. People knew how to raise any concerns and were encouraged to provide feedback about the care they received.
There was an open and positive culture within the home and communication was effective. Staff were supported to carry out their roles. The manager had systems in place to assess, monitor and review the quality of the service. These were used to drive improvements.
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 the report.