Background to this inspection
Updated
16 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was carried out on 26 February 2018 by one adult social care inspector, an inspection manager and a specialist advisor who was a nurse.
Before the inspection, the registered provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service. We also checked information that we held about the service and the service provider. We looked at any notifications received and reviewed any other information held about the service prior to our visit.
During the inspection we spoke with nine people who used the service, three people’s relatives three visiting social care professionals, a maintenance person, an administrator, a cook, the registered manager, the providers quality assurance and compliance manager, an activities organiser, seven staff who delivered care including two registered nurses and a senior care practitioner.
We spent time observing care and used the short observational framework for inspection (SOFI), which is a way of observing care to help us understand the experience of people who could not talk with us. We observed the administration of medicines in the morning and at lunch time. We also observed people’s lunch time experience and the provision of a group activity in the afternoon. Records reviewed included: Seven people’s care plans and daily records, staff rotas, policies and procedures, staff files covering recruitment, training and supervision, medicine administration records (MAR), accidents and incident records, complaints and audit documentation. We also looked at other areas of the environment including bathrooms, medication room, medication storage, communal lounges, people’s bedrooms, the dining room, cleaning cupboards and sluice facilities.
Updated
16 March 2018
This inspection took place on the 26 February 2018 and was unannounced.
At the last inspection of this service on 2 November 2016 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because equipment was not always used safely and requirements of the Mental Capacity Act 2005 were not always followed. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to meet the requirements of the law. At this inspection we found the provider had followed their action plan and they were now meeting the requirements of the law.
This service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service is registered to accommodate up to 42 people. At the time of the inspection 42 people were living at the service; some of whom were living with dementia and other chronic conditions. Of the people living at the service; 31 required nursing care and 11 required support with personal care.
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.
People received effective, personalised care that was thoroughly planned and had been adapted to meet their needs. They directed and agreed to their care and the principles of Mental Capacity Act were being applied. People’s end of life care was discussed and planned and their wishes respected.
People were supported to express their views, make choices about their care, and have maximum choice and control of their lives. People chose when to get up, what to wear, when to go to bed and how to spend their day. People had the opportunity to take part in group activities such as; painting, karaoke, bingo, visits from external entertainers, playing darts and using the in house ‘bar’. Staff spent time with people on a one to one basis and encouraged people to stay in touch with their families and receive visitors.
People were encouraged and supported to eat and drink well and there was a varied daily choice of meals on offer. Health care was accessible for people and appointments were made for regular check-ups as needed.
People felt well looked after and supported. We observed friendly relationships had developed between people and staff. Care plans described people’s preferences and needs in relevant areas, including communication, and they were encouraged to be as independent as possible.
Staff were supportive, caring and provided dignified care. They understood individual’s preferences and supported people’s lifestyle and social interests.
People's individual needs were met by the adaptation of the premises. Risks associated with the environment and equipment had been identified and managed. Technology, such as sensor mats, were used to alert staff if people at risk of falls got out of bed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.
We found that a safe service was provided by a staff team who were appropriately recruited, trained and supported. Established systems were in place for preventing harm and abuse. Robust arrangements had been made to protect against risks, maintain health and wellbeing, and give medicines safely.
The service had an open, inclusive culture and was well managed. Feedback was sought and responded to. Complaints had been recorded and responded to appropriately. The governance of the service ensured regular monitoring of standards and the quality of care provided. Where shortfalls were identified action had been taken to make improvements.