The people we observed were supported by kind, patient and caring staff who met their needs well. People were offered choices about what they ate, what they drank and where they sat. When help was needed this was offered very discreetly.
We found a significant improvement in the record keeping and auditing of the service since we last visited. We found the care to be safe, effective and it met people's needs.
People could not be sure that their care records were accurate and this could impact on their care as staff did not have clear and up to date guidance on all areas of need.
Relatives praised the acting manager for making significant improvements in the service. 'I have always been happy with the staff here. There have been times when it didn't have a nice feel to the place. Since the acting manager has come in, it has a lighter feel. I know there are things which could be better, but as long as the care is good I am happy. I hope the acting manager stays because she has turned it around. Staff are happier, they didn't used to be and that was down to the manager at the time. I think the staff attitude is better when they are delivering care. I think the improvements I have seen are down to good management.'
We found mixed evidence about dignity issues. Our observations showed that the staff have got better at making sure people are treated with dignity and respect. Relatives we spoke with also commented on the improvement, 'I am happy that my relative is here as it has improved so much and peoples respect and dignity is now maintained.' We saw some examples where this was not the case. A female was transported in a wheelchair, but the staff did not check that her skirt was pulled down over her knees. We also observed that staff still speak about people and their needs quite loudly in communal areas where others could hear, which compromises their right to privacy.
We found mixed evidence about how well people's care and welfare is being managed. The relatives we spoke with were very happy with the care being provided, they told us, 'the staff have always followed the instructions in the care plans, they are honest and above board, lovely people.' One person told us how much their relative had improved, 'this is much better that the last place she was in. They always encourage mum's independence here, she come on so much. I think it's brilliant here.' We also found that staff do not always move people in a safe way or update their plans of care when their needs change.
We observed the staff encouraging people to eat as much of their food as possible, especially people who need assistance. It was clear though that there were not enough staff to properly monitor people who either ate independently or needed minor assistance. For example we saw people pouring drinks onto their meal, getting up from the table and walking off and struggling to reach their cutlery.
We saw a number of good, warm and responsive interactions between people who live at the service and staff. The people we observed, for most of the time seemed settled and calm, and several spent some time in a positive mood, smiling and happy.
The relatives we spoke with told us they felt the staffing levels were sufficient and they could not identify particular times when the staff seemed to struggle to meet needs.
We found through our observations that the staff were patient, kind and caring. We noted, however that they struggled to know how to react when people refused help and became aggressive.
Relatives we spoke with told us the service has improved significantly, and they told us this is down to the new acting manager. 'It's a vast improvement. If I have any concerns I can go to the staff and it's sorted. The manager never promises anything, but deliverers everything. The morale throughout the entire home has improved I no longer have any concerns about the service.'