We spoke with three people using the service. They told us staff treated them with dignity and respected their privacy. One person told us, 'There is nothing about this whole place that is not in this category. You can't fault it.' Two people told us they had not seen a plan of their care and one person was not sure. One person said they had been involved in a review of their care.We spoke with two relatives. They told us staff treated their relatives with dignity and respect. They told us staff kept them informed and they had been involved in discussions about their relative's care.
However, other evidence did not support this. We saw assessment documents were written in the first person and included sections to record people's preferences and their views on the support needed. However, there was no place on the forms for people using the service or their relatives to sign. This meant it was not clear how they had been involved. We saw some care plans included the signatures of relatives, but we saw other care plans where neither the person using the service or their relatives had signed. No information had been added to explain why signatures had not been obtained. This meant there was a higher risk they had not been involved in decisions about the care.
People using the service told us staff provided support that met their needs and they felt safe. Relatives told us their family members were well cared for and were safe. One person told us the GP was called straight away if there were health concerns and said, 'I just think it is a wonderful care home' and, 'I'm just so happy with everything.'
However, other evidence did not support this. We saw assessments and care plans were in place for a range of needs. However, some documents lacked detail. We saw sections on forms for staff to tick to record they had reviewed the documents monthly. We saw they had completed evaluation forms to record monthly updates. However, some ticks were missing and the information in the evaluation forms was sometimes very brief. We also saw care plan review forms that had not been completed. This meant it was not clear if reviews had taken place and who had been involved in these.
People using the service told us they were happy with the arrangements for managing medicines. They told us they always got medicines on time and had no concerns. Relatives told us staff provided appropriate support and they had no concerns about medicines.
However, other evidence did not support this. The temperature of one clinic room was 32 degrees, which was not an acceptable temperature for the storage of medicines. We saw the temperatures of the fridges containing medication were being checked and recorded daily, but these had not been recorded on two days. We looked at the medication administration record (MAR) charts for seven people. We saw these were completed appropriately for six people. However, we saw a signature was missing on one day for one person.
People using the service said there were enough staff. The third person told us, 'I think sometimes we are a bit short staffed', but said, 'They'll respond straight away when the buzzer goes.' They said there were sometimes a lot of bells ringing. Relatives told us there were enough staff.
However, other evidence did not support this. We looked at the staff rota for a two week period and saw there were variations between days in the number of staff on duty. The variations meant there was a greater risk that people's needs were not met. We were told staff had been unable to arrange cover for staff who were sick or on annual leave.
People using the service told us they knew how to make a complaint and staff asked them about their preferences. One person said, 'I think it's excellent.' Two people told us they did not know about residents' meetings. Relatives told us they had not received surveys to complete. However, they said they felt listened to and knew how to make a complaint.