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Inspection report

Date of Inspection: 6 May 2014
Date of Publication: 26 June 2014
Inspection Report published 26 June 2014 PDF

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

We looked at the personal care or treatment records of people who use the service, carried out a visit on 6 May 2014, observed how people were being cared for and talked with carers and / or family members. We talked with staff, reviewed information sent to us by other authorities and talked with other authorities.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

Relatives who visited the home frequently, told us that staff “Take good care of people here.” They told us that the person using the service always looked clean and neatly dressed and one said that both they and the person using the service were happy at the home. We saw the results of the most recent relative’s survey in autumn 2013. It showed that all of the relatives who responded believed that people using the service received good care for their physical and emotional needs, and were treated with respect that promoted their dignity. Several questions had an improved response from the previous survey, including ‘access to manager and senior staff’, ‘rate the staff’, and ‘usefulness of relatives meeting’.

We looked at assessments and care plan files for four people using the service. Pre-admission assessments had taken place before they had moved into the home. A relative told us that the manager had come to their home to complete an assessment before they had moved into the service. Risk assessments related to service users’ social, emotional, physical and mental health needs and included mobility and communication risks. Records were individualised, comprehensive and person centered. Details were specific and personal, showing that people using the service or their relatives had been involved. The care plans were based on the assessments. Records included details of other health professional’s input at appointments including with General Practitioners, dentist, dietician and speech and language therapist.

We saw that people or their relatives had signed to consent to using the service’s laundry service, for regular hairdressing appointments and for podiatry services. Those that we looked at had all been reviewed in the previous three months; none of them included the signature of the person or their relatives, although there was a space reserved for people or their relatives to sign to say they had read and agreed to the plan of care.

Staff told us that relatives were always informed about changes to care plans and we saw that each file included a record of communication with relatives. One included a phone call to discuss a change in a person’s mobility. A relative told us that they had read and signed a pre-admission assessment and had read a revised care plan the previous year, and that they agreed with it but did not remember signing it. This showed us that, although some plans were not signed, the service made every reasonable effort to keep relatives informed and aware of care plans and changes.

Staff spoke with us about people and their needs in a way that showed us that they knew them well and we compared what they said to the details in care plans. We saw that this matched, which showed us that staff understood people’s preferences and needs. We observed staff interact with people throughout the day, and they were patient and kind.

The manager told us that a new activities co-ordinator had recently been appointed who had experience of dementia care. A second activities co-ordinator already worked at the home and showed us records of daily activities which included music and singing, art and craft work and walking in the gardens. They told us that many people benefitted from one-to-one sessions which included talking about their life story, hand massage and use of the new sensory room. We saw evidence that four relative volunteers had received training in the use of the sensory room equipment so that in the future there would be two sessions each week. Sensory equipment such as lights and music have been shown to be beneficial for older people with dementia and is supported by a number of organisations including the National Institute of Clinical Excellence (NICE). The NICE guidelines ‘Dementia: Supporting people with dementia and their carers in health and social care (2006)’ specifically mention the use of Multi Sensory Environments to manage anxiety and agitation in people with dementia in preference t