Archived: Cleeve Villas Care Services Limited

Previously we found that the provider did not have effective systems in place to ensure sufficient numbers of suitably qualified and experienced staff were on duty to meet people's needs. Staff rotas indicated an over reliance on external agency staff. During this inspection staff rotas we saw indicated an over reliance on external agency care staff.

We received information of concern following our last inspection that staff did not feel supported or have access to training and supervision. We found evidence during this inspection that confirmed this.

People told us they had not experienced any difficulty accessing medication hey required one person told us 'the nurse gives me the pills, I get them when I need them'. This was confirmed by our observations.

The provider had effective recruitment and selection processes in place. However we found the provider did not have sufficient numbers of suitably qualified staff to deliver care and support. People told us 'we haven't got enough nurses or enough carers'. We saw records that confirmed this. Staff we spoke with told us they felt supported, but felt they did not always have enough time to carry out their duties.

We saw that the provider had appropriate processes in place to assess and monitor the quality of service people receive. People told us they had the opportunity to raise any concerns and were confident they would be acted on.

During this inspection we saw the provider had implemented processes that had lead to improvements in the service. Staff we spoke with told us they felt supported by the new management structure and had received training and supervision. One person told us 'the consultants are the best thing that's ever happened to this place' The provider has improved the system for recording and assessing peoples care needs however we saw that when issues were identified they were not always followed through.

People told us they had the opportunity to give feedback about their experiences of the service. One person told us 'they asked me what I liked and what I wanted to do'.

We saw the provider had made improvements to the management and administration of medicines. People told us they received their medication when required and had not experienced problems with their medication. We saw evidence that confirmed this.

The safe handling of medicines was assessed by a CQC pharmacist inspector. The reason for this inspection was to follow up on a warning notice from the previous inspection on 15 October 2012. We looked at the storage of medicines, six people's medicine records, two care plans and spoke with two members of staff.

People told us they could give feedback about their experiences of care. We saw notes of meetings that confirmed this. However we did not see evidence of how the provider acted on this feedback. We had concerns about how the provider monitored the quality of the service and managed potential risks.

During this visit we saw that the provider had made some improvements to the management of medicines and quality monitoring of the service since our last visit. However the provider had not addressed all areas of concern identified and was not compliant with these outcomes.

People told us they felt safe and had never seen anything that caused them concern. They told us they received their medication when required and had not experienced problems with their medication. We did not see evidence to confirm this and identified concerns about how medicines are managed.

At our last inspection we raised concerns about the number of agency staff used by the provider. During this inspection we saw that less agency staff are now being used. People told us there were enough staff to care for them. They felt they had good relationships with staff and were cared for by an established team, that staff treated them as individuals and understood their needs.

People told us they could give feedback about their experiences of care. We saw notes of meetings that confirmed this. However we did not see evidence of how the provider acted on this feedback. We had concerns about how the provider monitors the quality of the service and manages potential risks.