The inspection took place on 7 and 9 April 2015. The first visit was unannounced and the second visit was announced. We last inspected the service on 25 April 2014. At that inspection we found the service was meeting all the regulations that we inspected.
Doric View is a purpose built bungalow providing short break accommodation for people who require personal or nursing care. The service can accommodate up to six people, at the time of our inspection there were four people using the service.
A new manager was in place at the time of our inspection. The manager was aware of their responsibility to apply to become a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We did not see evidence of MCA assessments and ‘best interests’ decisions being carried out for people who lacked capacity to make decisions for themselves. This meant people’s rights against inappropriate restriction of liberty were not protected because appropriate measures were not in place to make the required assessments and applications, in line with MCA and DoLS legislation.
People using the service told us they felt safe. One person said, “Yes safe, they look after me.” Another person said, “I’m happy here, I’m safe.” A relative told us, “I have no worries when [my relative] is here they are very safe.” Staff had a good understanding of safeguarding. We saw training records that showed all staff had received training relating to safeguarding.
Medicines records were up to date and accurate. This included records for the receipt, return, administration and disposal of medicines. This showed that people’s medicines were managed to enable them to receive them safely.
The service undertook very careful and detailed assessments of risks related to the care of people who lived there. The assessments showed that people using the service and their families were involved in assessments and their contribution was recorded.
We examined staffing rotas. People told us and our observations concluded there were enough staff to meet people’s needs.
Recruitment records for recently recruited staff held completed reference checks and a Disclosure and Barring Service (DBS) check dated prior to their start date. This meant the provider had undertaken the necessary checks to ensure staff were suitable to work with vulnerable people.
We saw it detailed action to be taken in the event of an emergency and was accessible to staff. This meant the provider had suitable plans to keep people safe in an emergency.
We looked at the accident and incident records. We saw information was collected, including types of incidents and times they occurred. As no trends were identified from the information analysis had been conducted.
We looked at record relating to the safety and upkeep of the premises. Records we viewed showed regular health and safety checks were undertaken. This included checks of gas safety, electrical safety, electrical appliances, fire safety and water safety. At the time of this inspection these checks were up to date. We asked people about meals. One person told us, “I like the food.” Staff told us that people can have their meals in a number rooms, it’s their choice. We saw a menu was available. Staff told us if a guest didn’t like the menu they would cook whatever they wanted for them.
We found that training and development was up to date. Training records contained a comprehensive record of appropriate courses with copies of training certificates. We also saw records of assessment of competence in regard to the management of medicines.
We saw records of supervisions and appraisals held, discussing working practices and training needs. Staff confirmed that appraisals were conducted annually and supervisions monthly.
At the entrance to the service a welcome book that gave details about the service including mission statement, aim and objectives, accommodation, medication, staffing and complaints and compliments. This information was also readily available in people’s rooms. This meant that people using the service and their families had access to up to date information about the service.
People told us the staff were caring and treated them well. One person said, “[Staff member] is lovely,” and “[Staff member] works really hard.” Another person said,” The staff are great and look after me.”
The atmosphere was happy and calm. All activities and chats involved the people who used the service. We saw people receiving plenty of attention from staff. Staff took the time to sit with people and chat and watch television with them.
We observed staff in many interactions with people who lived there. We saw that they were friendly and caring. Staff gave people time to express themselves and communicate. They ensured that people’s wishes were carried out.
People had diaries about their stay to show their parents or relatives where they had visited and what they have achieved. We saw one diary held postcards from the seaside and tickets from the show. A relative told us, “[My relative] can’t tell me what they have done during their stay, the diary gives me the information then I can talk to [my relative] about it”.
We examined records relating to compliments and complaints. The manager advised that no complaints had been received last year. However, the provider had a system in place to log and investigate complaints. We saw that a complaints policy and procedure was in place and was available to all within people’s room book.
The atmosphere in the home was friendly and relaxed and it was noted all staff were supportive of each other and clearly had positive working relationships. Staff told us they enjoyed working at the home. Staff told us they felt supported by the manager.
The manager had a comprehensive system to audit various aspects of the running of the service. These included checks of the medication systems, infection control, health and safety checks, audits of care plans and risk assessments and equipment checks.
We saw team meetings were held monthly to discuss issues within the service. Staff told us regular staff meetings were held. They said they were able to make comments and suggestions during these meetings.
You can see what action we told the provider to take at the back of the full version of this report.