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Inspection report

Date of Inspection: 17, 18 August 2014
Date of Publication: 24 September 2014
Inspection Report published 24 September 2014 PDF

Overview

Inspection carried out on 17, 18 August 2014

During an inspection in response to concerns

A single adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives, visitors and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is it safe?

Care was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw care plans that were sufficiently detailed to allow staff to deliver safe and responsive care. People told us they were happy with the care and support they received. A person who used the service said, "The carers do their work brilliantly, they are kind and patient and the nursing staff are wonderful. I think this is the only place that enables me to be as happy as I am.�

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had been submitted, proper policies and procedures were in place. Relevant staff were trained to understand when an application should be made and how to submit one.

We looked at the staffing levels and staff skills and experience and found that there were sufficient suitably trained staff to meet the people�s needs at Tusker House at this time. We however had received mixed comments from people and visitors about the staff provision before our inspection which was acknowledged by the management team. We were told, "We have recently changed shift patterns to overlap the times when it is busy, and this has addressed the staffing issues."

Systems were in place for staff to learn from incidents, accidents and near misses

Is it effective?

People had their needs assessed and individual care plans were devised. Before anyone joined the service, a pre-admission assessment took place.

Care plans were detailed and provided personalised information which enabled care staff to provide care and treatment which was individual to that person.

People maintained good health. The service worked closely with GPs, care coordinators and the local authority.

Systems were in place to monitor, assess and improve the quality of the service. Feedback was regularly obtained from people who used the service and their relatives.

There was a clear complaint policy and procedure in place that ensured complaints were handled and resolved appropriately.

Care plans were personalised and included information on the person�s life history and identity. This allowed for staff to provide care that was personalised and appropriate to that person.

We saw that there were systems in place to support staff. A member of staff said, �I love working here. It�s easy-going and a real family atmosphere. I can talk with [the manager], their door is always open.�

Is it caring?

Staff spoke with compassion and kindness for the people they supported.

People were supported by committed and attentive staff. Observations of care found that people were treated with dignity and respect. We were told, �[My relative] receives very good care here. Everyone is so friendly and approachable.�

Staff demonstrated a good understanding of the care needs of people who used the service.

People were encouraged to treat the service as their own home.

People were treated with dignity and respect.

It is responsive?

People told us that they felt happy and confident approaching staff with any concerns.

The staff we spoke with understood and respected people's choices and decisions.

People had their needs assessed and support from external health professionals' was sought where necessary.

Where's people's health had rapidly deteriorated we saw that the service took appropriate action.

People had access to activities which we saw they enjoyed and responded to.

Is it well-led?

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. Quality and compliance audits were regularly conducted. Where it was required, responses to the audits findings were developed and these were recorded.

Staff we spoke with had a clear understanding of why they were there and what their roles and responsibilities were.

The service had a business continuity policy in place. This made sure that each service had a plan in place to deal with foreseeable emergencies. This would reduce the risk of people's care being affected in the event of an emergency such as flooding or a fire.