We spoke with three people who used the service and eight staff including the acting care manager, visiting business manager and two team leaders. We looked at three people's care records. Other records viewed included staff training records, health and safety and quality checks, medication administration records, satisfaction survey results and the service improvement plan. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is a summary of what we found;
Is the service safe?
When we arrived at the service we gained access via a locked magnet controlled front door, we introduced ourselves to the office staff and signed in using the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.
Due to the majority of people living with dementia they were unable to specifically tell us if they felt safe but they told us they were happy. We saw that all staff interactions were kind and respectful. People were relaxed and accessed all areas of the service.
We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), which were updated every year. Some staff were still awaiting updates on some of this and other training, however the five staff we spoke with were able to tell us how they would report any concerns they might have. This meant that staff had the knowledge that they needed to ensure that people were safeguarded.
People were provided with their medication in a safe manner and at the prescribed times. We saw that medication was stored safely.
The service was safe. We saw records which showed that the health and safety in the service was regularly checked. This included regular fire safety checks, this meant that people were protected in the event of a fire.
Is the service effective?
People told us that they felt that they were provided with a service that met their needs. One person said, "Great place." Another person said, "I'm alright."
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.
We observed that at times the service did not have sufficient staff on duty to support people effectively during busy times. The provider told us that they would review the staff rota and dependency levels assessments which they used to assess people's needs to ensure that there were sufficient numbers of staff to meet their needs. They confirmed that they were going to protect mealtimes and increase staffing levels whilst they reassessed the level of staff required to support people's needs.
We saw that the service had not been conducting regular staff supervision and that training needed updating. The service had an improvement plan to address these issues and was in the process of arranging supervision for all staff and updating staff training.
Is the service caring?
We saw that the staff interacted with people living in the service in a caring, respectful and professional manner. People told us that the staff treated them with respect. One person said, "There is always someone to talk to and someone to talk to you."
We observed staff treating people with compassion and patience when they became distressed or disorientated.
Is the service responsive?
People's choices were taken in to account and listened to. We observed staff asking people what they needed and waited for them to respond before providing further support.
We saw from recent safeguarding information and other professionals visiting the service that the service responded to any concerns raised by people and staff and acted on these concerns. Action was taken as required to improve the service and stop events from reoccurring.
People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor, district nurses, mental health teams and chiropodists.
Is the service well-led?
Staff told us that they were happy with the recent management changes and that they felt comfortable accessing management and team leaders for support.
The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.