Background to this inspection
Updated
11 February 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on the 10 December 2015 and was unannounced. The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We did not send the provider a Provider Information Return (PIR) prior to this inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, we gave the registered manager the opportunity to provide us with information they wished to be considered during our inspection.
We reviewed information we held about the service. We looked at information received from people, from the local authority commissioners and the statutory notifications the registered manager had sent us. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority.
We spoke with three people who used the service and the relatives of eight people. We observed how staff interacted with people throughout the day. We spoke with the registered manager, the deputy manager, one nurse and three care staff and the activities coordinator. We looked at two people’s care records to check that the care they received matched the information in their records. We reviewed three staff files to check that staff were recruited in a safe way. We looked at the training records to see how staff were trained and supported to deliver care appropriate to meet each person’s needs. We looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.
Updated
11 February 2016
We inspected this service on 6 January 2016. The inspection was unannounced. At our previous inspection in November 2013, the service was meeting the regulations that we checked. The service provides accommodation and nursing care for up to 45 older people living with dementia. There were 43 people living at the home on the day of our inspection.
There was a registered manager in post. 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 2008 and associated Regulations about how the service is run.
Although the provider determined the staffing levels on an assessment of people’s needs, they had not taken into consideration the additional level of support people needed at specific times of the day. For example at meal times. This led to insufficient staff being available to meet people’s individual needs. The environment did not offer sufficient orientation and memory objects to support people’s memories and reduce confusion .Staff were knowledgeable about people’s care and support and understood what constituted abuse or poor practice and processes were in place to protect people from the risk of harm. Systems were in place and followed so that medicines were managed safely and people were given their medicine as and when needed. The provider had undertaken thorough recruitment checks to ensure the staff employed were suitable to support people.
Staff received training to meet the needs of people. Staff received supervision, to support and develop their skills. The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity in certain areas, capacity assessments had been completed to show how people were supported to make those decisions. Applications had been made for DoLS in line with legislation. People received food and drink that met their nutritional needs and were referred to healthcare professionals to maintain their health and wellbeing.
Staff were caring in their approach and had a good understanding of people’s likes, dislikes and preferences. Staff supported people to maintain their dignity. People were supported to maintain and develop their social interests. People felt confident that they could raise any concerns with the registered manager. There were processes in place for people and their relatives to express their views and opinions about the service provided. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement.