Archived: Heads Meadow

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found '

Is the service safe?

Only one person living at Heads Meadow was able to able to tell us what they thought about the support and care provided. When asked if they liked living in the home they replied 'Yes' and gave us a thumbs up.

Recruitment practices were safe and thorough. Care staff had received supervision and undertaken training in the safeguarding of vulnerable people. This ensured that staff were able to identify unsafe practices and take appropriate action to resolve them.

The registered manager organised the rotas, taking in to account people's care needs to ensure correct decisions were made about the numbers, qualifications, skills and experience of staff required. This helped to ensure that people's needs were being met.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care settings. While no applications had been submitted, appropriate policies and procedures were in place. Staff had received training in the Mental Capacity Act and the application of DoLS. Care staff were able to explain what actions they would take if they felt that people were unable to express their choices and wishes. A senior staff member explained that they were currently working alongside the funding authority to explore working practices within the home and whether they constituted any DoLS.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

There was a member of senior staff available on-call in case emergencies arose.

Is the service effective?

The home had access to an advocacy service if people needed it. This meant that when required people could access additional support.

People's care and welfare needs were assessed. Specialist dietary, mobility and equipment needs had been identified in care plans where required. It was clear from our observations and from speaking with care staff that they had a good understanding of the people's care and support needs.

The provider had effective systems in place for the obtaining, storage, administration, recording and disposal of medicines.

Is the service caring?

We observed that people were supported by attentive and caring staff. We saw that care workers showed patience and gave encouragement when supporting people. Records detailed people's likes and dislikes and we observed staff providing care in accordance with this.

Care staff we spoke with confirmed that they were responsible for reading people's care plans and for ensuring that they were up to date with any changes. They explained how people were encouraged in their own way to make daily choices. We saw people being supported throughout the day to make choices about activities they would like to do.

Is the service responsive?

People regularly attended a range of activities both in and outside the service. The service was situated close to local facilities. This helped to keep people involved with their local community.

People living in Heads Meadow had information on how to make a complaint available in an accessible format. We looked at how the home dealt with complaints. The home had not received any complaints since our last inspection.

Prior to the service starting people had their needs assessed. This information was then transferred in to a person centred care plan. This meant that the service was able to respond to the needs of each individual living at the home.

Is the service well-led?

The service worked well with other agencies, health professionals and family members to make sure people received consistency of care. Records contained details of appointments with health professionals and any outcomes.

The service had quality assurance systems in place. Records we reviewed showed that where issues had been identified actions had been taken to resolve them.

Policies and procedures were regularly reviewed throughout the year and were available for staff at all times.

Care staff were clear about their roles and responsibilities and the needs of the people they were supporting. This helped to ensure that people received a good quality service at all times.

Care staff told us they felt supported by the management and were kept up to date with any changes to the service.

The provider sent us an action plan which described how they planned to meet the compliance action. This included prioritising training in line with people's needs and staff development. The provider told us staff would receive regular formal supervision and attend regular team meetings.

At this visit we saw improvements had been made. The training matrix showed all staff had completed training on the Mental Capacity Act 2005 (MCA) in July 2013. Other training completed included management of skin integrity in September 2013. We saw arrangements were in place for staff to attend physical intervention training and a refresher course on safeguarding people before the end of 2013.

Since our visit to the service in May 2013 concerns had been raised by the local authority with regard to the care and welfare of the people using the service. At this visit we also looked at records relating to individual care needs.

In July 2011 we identified staff were not being regularly assessed on their competency to administer medicines. At this inspection we were told staff were regularly observed administering medicines.

We met and spoke with staff on duty about the care they provided, their training and the support they received. The staff told us they received training relevent to their role. The manager was unable to locate the training matrix to evidence the training staff had received.

We looked at three care plans and accompanying risk assessments. We saw staff had signed to confirm they had read and understood the risk assessments. Most of the people living at Heads Meadow had been there for many years and staff demonstrated a good understanding of their needs.

We found the quality assurance system was not effective at identifying shortfalls in the service.