4, 6 June 2014
During a routine inspection
As part of this inspection we spoke with seven people who use the service, the registered provider, seven care staff and the registered manager of the National Star College. We also reviewed records relating to the management of the home which included, five care plans, daily care records, infection control and environmental systems, staff information and quality assurance audits.
In this report the name of the registered manager does not appear. This is because the provider had submitted an application to add this location to the registration of the National Star College's registered manager. This application was being processed by the Care Quality Commission at the time of our inspection.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
Is the service safe?
People were kept safe because when people displayed behaviour which challenged others; staff managed it safely and respected people's dignity and protected their rights. Staff had a good understanding of the strategies in place to support people when anxious, upset or frustrated. When people were at risk, staff followed risk management policies and procedures to protect them.
People were safe because the service had a system to manage accidents and incidents and learn from them so they were less likely to happen again.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.
People were safe because staffing levels were assessed and monitored to ensure they were sufficient to meet their identified needs. The service considered the skill mix, competencies, knowledge, qualifications and experience when arranging staffing that would meet their individual needs at all times. A person living in the home said, "Staff are very nice, they are always free to help, I may have to wait sometimes in the evening but this is not a major issue. Staff are actually very good at their job". Concerns had been raised with us about the impact of staffing levels on meeting people's personal care and social needs. The provider had recognised problems due to the appointment of new staff and increased needs of some people living in the home. They had taken action to remedy this. One member of staff told us, "The deployment of staff is better, students are getting out more socially and there has been a significant improvement".
Is the service effective?
The service was effective because people's individual needs, choices and preferences were reflected in their care plans. People living in the home told us they had staff appointed to work closely with them (key workers). They said their key workers talked to them about their care needs. One person said, "Staff regularly talk with me about my care plan, too regularly!"
People received an effective service because referrals were quickly made to health services when their needs changed. People's routine health needs and preferences were met by a range of social and health professionals.
Is the service caring?
People received a service which was caring because they felt they were treated with kindness, compassion and dignity in their day to day care. Staff knew the people they were caring for and supporting, including their preferences and personal histories. Staff showed concern for people's wellbeing. People felt that staff took time to communicate with them in a meaningful way.
A person living in the home said, "Staff are very nice, they are always free to help'. Another person told us, 'Staff are kind. They have a good sense of humour'. We observed staff treating people patiently, sensitively and respectfully. One person said, 'Everyone talks to me like a man'.
Is the service responsive?
People received a responsive service because they received care, treatment and support when they needed it. People were asked about what was important to them. People's individual needs were regularly reassessed and any changes in their care were reflected in their care plans and risk assessments.
The service was responsive because people received the support they needed when they moved between services and their needs continued to be met. People's private information was respected by staff, whilst ensuring they acquired and provided the necessary information when people were moving between services. Transition (when leaving college) was properly planned, and supported the individual through the process.
People received a responsive service because they knew how to share their experiences or raise concerns or complaints and felt comfortable doing so. They told us they could talk to staff individually, at house meetings or talk to people or staff at the college. One person told us concerns raised with staff would be listened to. Another person told us "New staff should have training before they start work". In response people living in the home were to be asked if they would mentor new staff as part of their induction.
Is the service well led?
The service was well led because staff knew and understood what was expected of them. Meetings had been held with staff where they discussed their roles and responsibilities. Staff had commented to the provider, "team more organised", "significant changes to working structures".
Robust quality assurance and governance systems were in place and used to drive improvements across the service. We saw records of audits completed in June 2013, November 2013 and April 2014. These evidenced continuing improvements within the home. Management enabled and encouraged open communication with people, those that mattered to them and staff. People and staff had meetings with management and the provider. They were listened to and given feedback about any action taken to improve the service.