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Inspection report

Date of Inspection: 15 November 2012
Date of Publication: 23 January 2013
Inspection Report published 23 January 2013 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 15 November 2012, talked with people who use the service and talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We spoke with three people who were using the services. The people we spoke with told us that they felt they were well cared for. One person said, “I feel well looked after and they [the staff] meet my needs.”

We looked at the care plans for three people who were using the service. A care plan should document a person’s needs and how staff can meet those needs. The care plans we saw contained clear guidance to staff about how they could meet people’s assessed needs.

A completed “My life plan” was in place at the front of the file and this linked into the risk assessments and care plans that were in place. This document had not been signed by the service user; however the accompanying support plans were signed. The “My life plan” document gave information about the person’s goals, support needed, the skills they had and the intended outcome of the care package for the person using the service.

The care plans were split into sections each describing the person’s skills and the support they needed in various aspects of their day to day life. Plans were detailed and gave person centred guidance about how to meet the person’s needs. The care plans were written in a way that suggested people had choices about their day to day life, for example, “I will buzz when I want to get up.” The care plan contained extra guidance about how support should be changed when the person was feeling unwell.

A Malnutrition Universal Screening Tool (MUST) was in place, within each care plan reviewed however in one of the care plans no MUST score was provided and no further review carried out. The manager stated there was no risk to this person and that this would be reviewed in line with the full care plan review. It was acknowledged that documentation currently did not reflect this position.

Otherwise, risk assessments were in place which linked to the care plans. There was also evidence recorded of the activities and medical appointments attended by the service user.