16 May 2017
During a routine inspection
This was the first inspection since the home was acquired by the registered provider in November 2016. It was carried out because of concerns raised with the Care Quality Commission on 8 May 2017. These related to staffing, care, equipment and staff support. This inspection was carried out on 16 May 2017 and was unannounced.
At the time of the inspection there was a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found breaches of legislation in relation to safe care and treatment and good governance.
We found shortfalls in the way some medicines were being recorded and monitored. We also found that some medicines had been allowed to run out and staff did not obtain further supplies in a timely manner. This meant that medicines were not being administered consistently.
We found some anomalies with the care plans of two people in the home and found that monitoring of care could be improved and be more consistent.
We found the checking and auditing systems of medicines and care plans needed improving to ensure shortfalls were being identified and addressed.
You can see what action we told the provider to take at the back of the full version of this report.
Staff sought consent from people before providing support. When people were unable to consent, the principles of the Mental Capacity Act 2005 were followed in that an assessment of the person's mental capacity was made and ‘best interests’ decisions were recorded. When necessary, referrals had been made for a Deprivation of Liberty [DoLS] authorisation. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. The applications were being monitored by the manager of the home.
People said they were happy with the care they received, their privacy was respected and staff were careful to ensure people's dignity was maintained. We saw that staff interacted well with people living at the home and they showed a caring nature with appropriate interventions to support people. People we spoke with and their relatives felt staff had the skills and approach needed to ensure people were receiving the right care. People felt involved in their care and there was evidence in the care files to show how people had been included in key decisions. People were appropriately referred to health care professionals for treatment and advice.
People said they enjoyed the food and they were offered choices. The evening meal time was seen to be a relaxed and sociable occasion. A range of social activities were organised and people told us they were consulted about what activities they would enjoy.
We saw required checks had been made to help ensure staff employed were 'fit' to work with vulnerable people. Appropriate safeguarding policies and procedures were in place and staff told us they would raise any concerns they had with the management team.
We found there were sufficient staff on duty to meet people's care needs. Staff said they were supported through induction and the home's training programme.
The home was well maintained and clean. Recent redecoration had taken place, a new call bell system had been installed and there were plans to make further improvements to the environment.
We saw a complaints procedure was in place and people, including relatives, we spoke with were aware of how they could complain. We saw there were records of complaints made and action taken as a result.