31 August 2017
During a routine inspection
The service had a registered manager who was appointed on 24 June 2016. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. 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.
People valued their relationships with their allocated staff and felt that they consistently went ‘the extra mile’ for them, when providing care and support. As a result, they felt really cared for and that they mattered.
The service consistently provided outstanding end of life care which ensured people experienced a comfortable, dignified and pain-free death. Staff also cared for and supported the people that matter to the person who was dying with empathy and understanding.
People were supported by staff who made them feel safe. People and relatives told us the continuity and consistency of staff was very good, which reassured them and lessened their anxiety. People were kept safe by staff who understood their roles and responsibilities in relation to safeguarding procedures and how to protect people from harm and abuse.
People’s support plans and risk assessments identified how potential risks should be managed to reduce the likelihood of harm occurring to people. Staff understood the risks to people and provided their care safely in accordance with their support plans.
The registered manager and care coordinator completed a daily staffing analysis to ensure there were sufficient staff available to meet people’s needs. Staff had undergone relevant pre-employment checks as part of their recruitment, which had been verified by the provider. People were protected from harm because the provider had assured that staff employed were of suitable character to support people safely.
People’s medicines were administered safely, by trained staff who had their competency to do so regularly assessed by managers.
Staff had the required skills and knowledge to provide the support people needed. Records demonstrated that required staff training was up to date which ensured that staff had been supported to gain the necessary skills required to meet people’s needs and to maintain them.
The management team effectively operated a system of spot checks, supervision, appraisal and monthly meetings which supported staff to deliver care based on best practice.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice
People were protected from the risks of malnutrition and supported to eat a healthy diet of their choice, by staff who had completed training in relation to food hygiene and safety.
Staff demonstrated concern for people’s wellbeing in a meaningful way and responded to their healthcare needs quickly when required.
Staff had developed caring relationships with people and knew about peoples’ needs and the challenges they faced. Staff understood people’s care plans and the events that had informed them.
The registered manager was committed to ensuring people were involved as much as they were able to be in the planning of their own care. There was guidance for staff about how to support people to promote their independence and maximise the opportunity to do things of their choice.
Staff understood people’s different communication needs and ensured they followed the guidance provided in people’s care plans to enable them to communicate their views.
Without exception, relatives of people being supported to live with dementia praised the continuity and consistency of staff provided to support their loved one.
People received person centred care that was responsive to their needs and focussed on them rather than the requirements of the service. People’s needs were assessed and regularly reviewed to ensure their care and support was responsive to changes identified.
The management team sought feedback in various ways such as quality assurance visits, satisfaction surveys and telephone calls. The registered manager ensured this feedback was acted upon through staff meetings and supervisions.
People had a copy of the provider’s complaints procedure in a format which met their needs. Complaints and concerns formed part of the provider’s quality auditing processes so that on-going learning and development of the service was achieved. People and relatives felt that staff listened to their concerns, which were quickly addressed.
Without exception people and their relatives praised the quality of the support they received and told us that the service was well-led.
The provider had adopted a clear set of values based upon caring passionately about people, supporting and enabling them to live life to the full and delivering person centred care which met their needs.
The registered manager was highly visible and regularly went to see people if they were upset or had raised concerns. The registered manager provided clear and direct leadership to staff who had a good understanding of their roles and responsibilities.
The registered manager effectively operated systems to assure the quality of the service and drive improvements. The provider ensured the service delivered high quality care by completing regular audits, site visits and reviewing the registered manager’s weekly monitoring report, which detailed all significant events. People’s and staff records were stored securely, protecting their confidential information from unauthorised persons.