We found that people were consulted about the care and support needed and were able to make choices about this. Care and support was provided in ways which met people's needs and this was reviewed regularly. Staff had received training in relevant areas and were able to access supervision sessions to discuss their work. Systems were in place to monitor the quality of the service provided.
We found that improvements had been made to how individual needs were assessed and support plans put in place. Records of care and support provided were often incomplete but tended to show more support had been provided than the support plan identified. We found that staff had received training in safeguarding vulnerable adults and were aware of what procedures were in place. However, the procedures were not complete in that two aspects were yet to be covered. Supervision sessions had been booked for staff but it was not known which staff required annual appraisal. Training was being sourced and staff were being booked onto training courses relevant to their work. Overall, improvements were seen but more time was needed to ensure these improvements continue.
However, we found that the provider had not assessed people's needs, that support plans had not been put in place to ensure staff knew how to meet people's needs and that care needs were not reviewed. We saw some daily records which showed complex health and social care needs but these had not been identified in a support plan and risk assessments had not been put in place, which put people at risk.
The provider did not have policies or procedures in place to ensure staff knew what to do if there was an allegation or suspicion of abuse and the manager did not know the process to follow.
Staff had varying levels of training and the provider was not supporting them with supervision or annual appraisal. There were no systems in place for the provider to monitor their services to ensure themselves of the quality of the service and to make improvements.