On this routine unannounced inspection we spoke with all five people living at William Street, two relatives, four members of staff and the manager.
We considered all the evidence we had gathered under the outcomes we inspected. This is a summary of what we found:
Is the service safe?
A person using the service told us that they felt safe in their home. A relative told us, "Staff are well trained and know what X needs. They are spot-on about safeguarding." The relative told us about a safeguarding issue the service had identified in the past. Safeguarding is protecting people's wellbeing and human rights, enabling them to live free from harm, abuse or neglect.
Each person had a health action plan that outlined the actions to be taken to promote and maintain good health. Referrals had been made to health professionals and their advice and treatment plans had been recorded.
Risk assessments were in place to identify and reduce risks in relation to people's health and daily living needs. The assessments had been reviewed regularly.
Systems were in place to learn from accidents, incidents, complaints and investigations. This improved the quality of the service.
The design and layout of the service provided spacious accommodation that was safe and well maintained. Security systems ensured the building was safe at all times and plans were in place for foreseeable emergencies.
We monitor the operation of the Deprivation of Liberty Safeguards 2009 (DoLS) which apply to care homes. Correct policies and procedures were in place and staff knew how to make applications. No DoLS were in place at the time of our inspection. One application had been made to restrict access to the kitchen for one person to ensure their safety. The local authority, that determine the applications, decided that the matter was being dealt with appropriately by the service to manage the risk and a DoLS restriction had not therefore been needed.
Is the service effective?
People's needs were assessed prior to moving to live at William Street. Care plans were reviewed regularly to ensure people's needs continued to be met
People were involved in planning their care. If they did not have capacity, relatives were involved to ensure their best interests were followed.
The design and layout of the building provides suitable and safe surroundings. The building has been adapted to support people with physical impairments. Ongoing maintenance and upgrading of the facilities means that people's physical needs could be met appropriately and safely.
There were effective staff recruitment procedures in place with checks to ensure that people were protected from potential harm by unsuitable staff.
Disciplinary action had been taken in relation to members of staff when practice had fallen below acceptable levels. .
Is the service caring?
Some people with complex needs were unable to share with us their views of the service. We observed that staff engaged well with people who responded positively expressing their views by non-verbal means. People seemed happy and comfortable with staff who involved them in our inspection. Staff were able to confirm written information we had seen detailing people's personal preferences about the way they wished to be supported.
A relative told us, "X has settled well and loves it here. Staff listen to concerns and take action". Another relative told us, "We are immensely happy with the way X is cared for. Staff are well trained and know what X needs."
Is the service responsive?
A person living at William Street and a relative we spoke with were aware of the complaints procedure. A relative told us that the service had responded to issues they raised.
When people's health care needs changed external health professionals were contacted. Their actions and recommendations had been recorded and acted upon.
Minutes of residents and staff meetings showed that actions had been taken to make changes to the service when needed. Staff told us that they felt confident in raising any concerns they had about the service.
Is the service well-led?
Systems were in place to monitor the quality of the service. We saw that shortfalls had been identified and addressed. This ensured the provider was able to protect people against the risks of inappropriate or unsafe care.
Regular staff meetings were held. Staff told us that they felt listened to and could raise any areas of concern.
Staff were clear about their roles and responsibilities. They felt supported with training and supervision and told us they could speak to the manager at any time.