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Inspection report

Date of Inspection: 27 April 2011
Date of Publication: 28 June 2011
Inspection Report published 28 June 2011 PDF

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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

Our judgement

People had experienced effective, safe and appropriate care, treatment and support that met their needs, but had not always protected their rights.

User experience

Of the people we spoke to in the home all said they had been very satisfied with the care and support from the staff. They said they received the support they needed with such as mobility, bathing, dressing, meals, seeing their GP if they had been ill and so on.

One person said they had not been comfortable in the sling hoist provided to help with mobility. Another said they preferred to live at home but realised this was not possible and so made the best of and accepted what they had. A third person said they did not wish to talk about anything personal and this was respected. They did talk about the food provided, about their feelings of having lost everything in life now, spouse, their home, their children and particularly their independence. They also said there was very little to do in the home and that they only went out with family.

People said they received help with their medication and finances and either the home, staff, or their family members, daughters and sons, took responsibility for these things.

Other evidence

In April the provider submitted a PCA document to the CQC which described how the home was compliant with the outcome and all of the elements that formed the outcome. The PCA was in the provider's own format and it stated that the home had not been completely compliant with the outcome as there had been minor concerns identified with care plans and recording of updated information about 'best interest' meetings, living wills and such as Power of Attorney.

We interviewed staff about the welfare of people and discussed this with the management team. We were told that people had assessments of need and risk assessments carried out which had been translated into care plans with action plans. Staff said they had used care plans to provide the right support to people and that the staff team and people in the home benefited from good routines and good team work.

In October 2010 the East Riding of Yorkshire Council (ERYC) had investigated a complaint that was 'upheld' and had questioned the care of one person in relation to bathing, pressure care and medication. It also highlighted that pre-admission assessments had not been carried out and communicated information had been conflicting.

We viewed two people's case files and looked in care plans and found they contained appropriate documentation: needs assessments, risk assessments for moving and handling, mobility, falling, nutrition and pressure care, also reviews of care, daily diary notes, monthly summaries, monitoring charts and so on. People also had patient passports for admission to hospital. Diary notes related the care people had received and reviews of care kept up with the changes people experienced and why.

Case files we viewed had not contained any information about 'best interest' meetings, who had Power of Attorney and so on as stated in the PCA, but these may not have been necessary. The management team had been aware of the shortfall for someone however, and had addressed the issue in an action plan in the PCA. Care plans were in the process of being re-written to include a more up-to date and person-centred approach. Some, but not all had been completed. The staff training record showed only one staff from thirteen carers had completed an 'effective person-centred care' course. This is addressed in outcome 14