Archived: The Bay

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.

Recruitment processes did not have all required checks and information about staff was not in place. A range of individual and generic risk assessments were in place and these were kept updated; staff encouraged people to be independent but important risk information to support some of their independent activities was not in place and could place them at risk. There was not enough staff available to ensure everyone’s activity needs and preferences could be met throughout the week or that a good standard of cleaning was maintained in the service. Staff understood people’s individual care and health needs but required more information about how to support some specific health conditions in accordance with national guidance. Staff interactions with people were seen to be appropriate, kind, and caring. People were relaxed in the company of staff and said they were happy and felt safe.

Staff knew how to protect people in the event of a fire as they had undertaken fore training and took part in practice drills, but people’s individual evacuation plans to inform staff of their specific needs in evacuation were not in place.

A range of audits and quality checks were in place but these had not highlighted the issues found at inspection and were not used effectively to identify and act on shortfalls in the service. People wanted more information but were not always provided with information in formats they could easily understand. People and relatives were asked to give their views about service quality but their feedback was not always analysed sufficiently to inform service improvement.

The premises provided a comfortable home for people but wear and tear in some areas required redecoration; repairs were not always completed in a timely manner. Equipment checks and servicing were regularly carried out to ensure the premises and equipment used was safe. Fire detection and alarm systems were maintained Guidance was available to staff in the event of emergency events so they knew who to contact. is

Staff received induction to their role and training to give them the skills and knowledge needed. Staff were supported through supervisions and appraisal of their work performance and personal development. Staff had been trained in how to protect people; they knew the action to take if they suspected or witnessed abuse towards people. They were confident they could raise any concerns with the registered manager or outside agencies if this was needed.

People’s routines were flexible and staff supported them in accordance with their support plans. Staff respected people’s dignity and privacy. Staff were trained and understood the strategies they needed to use in supporting people whose behaviour could be highly anxious or challenging. Staff understood and worked to the principles of the Mental Capacity Act 2005.

People chose what they wanted to eat and said they enjoyed their food. People were supported to attend health appointments and staff ensured appropriate referrals were made to assure people’s health and wellbeing.

People were kept informed about the complaints procedure and relatives felt confident of raising concerns with staff if necessary. People were given opportunities to meet with staff to discuss their care and treatment. A relative confirmed that they were kept informed and had been consulted about the persons care and treatment plan.

People were supported by staff to maintain important relationships. Relatives were always made to feel welcome and they and other professionals said communication was good. Staff felt supported and able to express their views.

Accidents and incidents were monitored by the provider to see where improvements could be made to prevent future occurrence. Policies and procedures were updated centrally and sent around for staff to read to ensure staff worked to current guidance. The registered manager ensured agencies including the care Quality Commission were informed of significant events.

We have made four recommendations:

We recommend that the provider review guidance in relation to the development of personal evacuation plans in line with their responsibilities under current fire legislation Regulatory Reform (Fire Safety) Order 2005.

We recommend that the provider ensure that individualised condition specific support plans for Diabetes are developed in accordance with guidance from Diabetes UK.

We recommend that the provider reviews current best practice guidance around the availability of information in formats suitable for people to understand.

We recommend that the provider review concerns and complaints procedures to ensure that this is fully accessible and representative of the experiences of people in the service.

We recommend that support to develop people’s independence and life skills is shown clearly through the setting of achievable goals and the monitoring of progress towards these

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.

Another person being assisted at the time was in a very low mood and needed a great deal of patient support. The staff member explained how the morning had gone and showed their in-depth knowledge of the person.

People told us they liked living at the service. A person told us they liked going into town with staff and they enjoyed line dancing which they participated in. A person told us they liked their bedroom and another person told us they enjoyed baking for people at the service.

We spoke to a professional linked to a person who lived at the service and they told us that the team and the manager were very good. The staff were keen to involve professionals and invited feedback from them.

During the inspection we found that people's independence was promoted and people were involved in activities they enjoyed. People's care needs were met but decisions were not always recorded. The environment was suitable but there were areas that required maintenance. Staff were well supported and there were systems in place to monitor service delivery.