18 June 2015
During a routine inspection
We inspected Kay Sera Sera on 18 June 2015. The service is registered to provide support and accommodation for up to four people living with dementia. At the time of our inspection, four people used the service. At the last inspection of the service on 2 April 2014, we asked the provider to make improvements in the following areas: How people’s medicines were managed, ensure adequate staffing levels and how the quality of the service provided was assessed and monitored to ensure that people received safe and good quality care. During this inspection, we found that improvements had been made in how people’s medicines were managed and in ensuring sufficient staffing levels; however further improvement was needed in the way the proprietors monitored the quality of 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 and associated Regulations about how the service is run. The service was managed by the owners, whom we refer to as ‘the proprietors’ in this report.
People’s care records did not always reflect the care they received. People did not always have risk assessments and management plans in place to guide staff on how care should be provided. This meant that people were at risk of receiving inappropriate care that did not meet their needs.
The provider did not consistently follow the guidelines of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that people were not being unlawfully restricted of their liberty. Staff did not always have a good understanding of the relevant requirements MCA and DoLS. The MCA and the DoLS set out the requirements that ensure where appropriate; decisions are made in people’s best interest when they are unable to do this for themselves. This meant that people’s liberties were at risk of being restricted.
Action had not been taken to ensure that improvements had been made against all the areas identified for improvement during the last inspection. Newly recruited staff did not have an induction. The provider did not always ensure that staff received relevant training to ensure that they carried out their roles effectively.
People told us they felt safe and protected from harm. Staff understood what constituted abuse and knew what actions to take if abuse was suspected. There were appropriate numbers of staff employed to meet people’s needs. People’s medicines were managed safely.
People were cared for by staff that knew them well and understood their care needs. Staff understood their roles and responsibilities and provided care in line with these.
People told us they liked the food and were supported to eat and drink adequate amounts. People were offered a choice during meals. People were supported to attend healthcare appointments and staff liaised with their GP and other healthcare professionals as required in order for people’s health and social care needs to be reviewed.
People told us and we observed that staff were kind and treated them with dignity and respect. People’s care was tailored to meet their individual needs. Care plans detailed how people wished to be cared for and supported. People were involved in the care planning process and in decisions about their care and treatment. People and their relatives told us that the provider responded to their concerns appropriately. There were systems in place to deal with complaints and concerns.
People who used the service, their relatives and the staff were very complimentary about the registered manager of the service. They told us the proprietors were always available and were approachable. We observed that the proprietors had a hands-on management style. People and their relatives told us they provided feedback and obtained information about services on a regular basis.
We identified that the provider was not meeting some of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 we inspect against and improvements were required. You can see what action we have told the provider to take at the back of the full version of the report.