We spoke with the majority of the people who used the service; some people welcomed discussion with us, some people did not. Some people were unable to speak with us due to frailty but we spoke with three visitors on their behalf. We spoke with the nurse in charge and staff of all grades and job descriptions. We spent time sitting in the communal areas observing how staff and people got on with one another. We saw that many people stayed in their own rooms for most of the day this being their personal preference, their ill health and frailty. No structured activity was arranged for people to participate in and enjoy.
Some people were able to discuss how they wished their care to be provided. Some people were unable to do so. We spoke with some visitors who told us that generally they were satisfied with the care provided but felt that the standard of care had decreased.
We spoke with staff about the care and support they provided to people each day. We looked at a selection of care plans and records and found that the information did not correspond with what the staff had told us.
People told us the meals provided were okay but not much choice or variety. Staff told us that people could have whatever they wanted to eat and drink. We saw this not to be the case when we observed the main midday meal. We saw that where people had been assessed as being at risk of malnutrition the monitoring forms had not been updated or completed.
People who used the service were not always protected from the risk of abuse or harm. Staff we spoke with were unsure of the procedures for dealing with any concerns or suspicions of abuse.
People were not protected from unsafe equipment. We found essential items of equipment to be faulty, not fitted correctly, unsafe, and not fit for purpose.
There were not enough qualified, skilled and experienced staff to meet people's needs.
We were unable to gain access to the main office where the records for the running of the home were kept, so we were unable to determine the way the service monitored the safety and quality of the service.