13 September 2016
During a routine inspection
This comprehensive inspection took place on 13 September 2016 and was announced.
The provider is required to have a registered manager as one of their conditions of registration. A registered manager was not in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the agency. 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. A manager had been in post since mid-July 2016 and was applying to be the registered manager.
People were kept safe and staff were knowledgeable about reporting any incident of harm. People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service. People were supported to take their medicines as prescribed and were enabled to be independent with this if they were safe to do so
People were supported to eat and drink sufficient amounts of food and drink. They were also supported to access health care services and their individual health and nutritional needs were met.
The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA 2005] and the Deprivation of Liberty Safeguards [DoLS] and to report on what we find. The provider was aware of what they were required to do should any person lack mental capacity. People’s mental capacity was assessed and care was provided in their best interests. Staff were trained and knowledgeable about the application of the MCA.
People were looked after by staff who were trained and to do their job. However, staff morale was low and the manager was aware of this. They were taking action to remedy this situation. Staff were now receiving one-to-one and group supervision.
People were treated by kind, respectful staff who they liked and they were enabled to make choices about how they wanted to live. People and their relatives were given opportunities to be involved in the review of their individual care plans.
People were supported to be part of the community; they were helped to take part in recreational and work-related activities that were important to them. Care was provided based on people’s individual needs. There was a process in place so that people’s concerns and complaints were listened to and these were acted upon.
The manager was supported by a team of management staff and care staff. There was a high usage of agency staff and there had been four different managers in the last 12 months. The staff considered that these two factors had a negative impact on their morale and effective team work. The manager had identified these issues and was taking remedial action to resolve these concerns.
Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action was taken where improvements were identified.