Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with five people who used the service and two relatives and asked them for their views. We also spoke with three staff members, the administrator, the manager and the provider. We also looked at some of the records held in the service including the care files for three people. We observed the support people who used the service received from staff and carried out a brief tour of the building.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 caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found-
Is the service safe?
Equipment at the home had been well maintained and serviced regularly. A person who used the hoist told us, 'There are always two staff to hoist me, one cannot manage it. I am made as comfortable as I can be with straps under my legs. I have no complaints, I feel safe when they use it.' A staff member told us one person, 'Likes me to hold onto the (wheel)chair as she gets out, it makes her feel safe.'
Staff personnel records contained all the information required by the Health and Social Care Act, although we have pointed out to the provider that there was not a full previous work history for all staff.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.
Is the service effective?
People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. One person told us. "I am looked after very well, I couldn't be happier.' A relative told us, 'The care plans have improved a lot.'
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. We spoke with one person who used the service who we had spoken with on a previous visit. The person told us, 'I am glad you have remembered to come and speak with me, the staff are a lot better now, it is nice to be looked after by someone who cares.'
Is the service responsive?
People's needs had been assessed before they moved into the home. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. A relative told us they had mentioned something had not been right for their relation and staff had responded promptly. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.
Is the service well-led?
We saw the care planning process recorded what people felt they were able to do for themselves and what they felt they needed support to manage. A relative told us, 'The care plans have improved a lot.'
Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Staff told us they were clear about their roles and responsibilities. A staff member said the home was run well. They said they thought communication had improved under the new manager. A staff member said they were encouraged to speak out and felt there was communication to and from management. One staff member said, 'The manager has always got time to listen to what we (staff) have got to say.'