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Inspection report

Date of Inspection: 5, 6, 10 September 2013
Date of Publication: 31 December 2013
Inspection Report published 31 December 2013 PDF


Inspection carried out on 5, 6, 10 September 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We also spoke with three people who use the service, three relatives, and ten members of staff.

When we reviewed people�s care plans we found evidence of some service users� involvement in making decisions about their care was absent. Relatives told us they were involved in annual reviews of care for their family members. However, one relative told us they were not involved in this year�s review, because the date had been changed at short notice and they were unable to attend the new date offered. Although we observed occasions where staff treated people with respect, and involved people who use services, we also observed occasions where they did not.

One person who uses the service we spoke with said �I can assure you, the quality of care is very good�. One relative told us �staff are caring� and another told us their family member was �well looked after and cared for�. When we spoke with staff, they were able to describe how they would support people who use the service to meet their needs. However, we found one person had not seen the dentist or optician for two and a half years. We saw some risk assessments were in place, but others were out of date or had not been completed at all. Care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare.

The provider did not have effective recruitment and selection procedures in place. Not all of the relevant checks had been completed before staff began work.

The provider did not take appropriate steps to ensure that, at all times, there were sufficient numbers of suitably qualified, skilled and experienced staff on duty. There was a risk they would not be able to safeguard the health, safety and welfare of people who use the service.

When we spoke with staff they told us they felt well supported by managers and they had enough training to enable them to meet the needs of the people they supported. However, when we looked at staff training records we found the provider did not ensure that staff were properly trained and supported to provide care and support to people who use the service. There was risk that staff would not be enabled to carry out their role effectively.

The provider did not regularly assess and monitor the quality of the services they provided. They did not identify risks relating to the welfare and safety of people who use the service. The provider did not have regard to the comments made, and views expressed, by people who use the service, and those acting on their behalf. The provider did not ensure that people�s personal records were accurate. Records required to protect people�s safety and wellbeing were not being maintained. Other records in relation to people employed by the service were not accurate.

We have made a referral to the local authority safeguarding adults team, due to the concerns raised from this inspection.

We spoke with the person managing the service on the day of our inspection. Throughout this report, we have referred to this person as the acting manager. The location did not have a registered manager at the time of our inspection.