19 June 2018
During a routine inspection
The service did not have a registered manager at the time of our inspection. There had not been a registered manager in post for a period of eight months. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The present service manager told us they were going to apply for registration with us. We will monitor the progress of their application when it is received.
When we last visited the service, the provider was in breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Some people did not have a suitable plan in place to guide staff in how to meet their needs.
During this visit, we saw improvements had been made at the service and people who were receiving care did have a care plan in place. However, there were further improvements needed to fully document people’s preferences in relation to their care.
People felt safe and were supported by staff who knew what action they should take if they suspected abuse. Risks to people’s health and safety were assessed and measures were in place to reduce the risk of harm to people. People’s needs were met by a regular group of staff who arrived on time and gave people the support they needed. When needed people were provided with medicines by staff who received the required training. People were protected by the prevention and control of the spread of infection and action was taken in response to any accidents or incidents which occurred when the service was being delivered.
The majority of people’s needs were assessed using nationally recognised assessment tools, however one assessment tool used had been modified for use by the provider but had not been validated and tested for reliability.
People were supported by staff who had received an induction when they commenced working at the service and training relevant to their role. When required, people were supported to eat and drink enough and were supported with their health care needs. Staff were provided with information about people’s health conditions and supported people should they need to access health professionals.
The service was not working within the principles of the MCA. People were not always supported to have maximum choice and control of their lives to ensure staff supported them in the least restrictive way possible. There was no evidence of capacity assessments or best interest meetings, for people who may lack the capacity, to make their own decisions to ensure any decisions made for people were the least restrictive and in their best interests.
People were supported by staff who were respectful, kind and caring towards them. People’s views on their care were considered and staff worked to maintain people’s privacy and dignity when providing care.
The majority of complaints and concerns raised by people to the service were dealt with appropriately. However, one person told us their complaint had not been resolved to their satisfaction. Following the inspection the service manager sent us information to show they had addressed this issue.
There was a lack of evidence in care plans of people’s end of life care or advance care decisions to show what their preferences may be.
The service manager and their management team were open and honest. They were supportive towards people, their relatives and the staff who worked at the service. The quality assurance systems in place were used effectively to monitor performance and quality of care. The registered manager responded positively to changes and used information to improve the service and care people received.