We visited this service and talked with people to gain a balanced overview of what people experienced, what they thought and how they were cared for and supported. We spoke with five people during our visit. We spoke with four members of staff and the manager. Some people using the service had limited verbal communication skills. We observed how people were cared for and how staff interacted with them during our visit to get a view of the care they experienced. We looked at the care records of two people.We considered all of the evidence that we had gathered under the outcomes that we inspected. We used that information to answer the five questions that we always ask;
Is the service safe?
We saw that people's individual needs had been assessed and that there were enough suitably trained staff to care for people in the way they wanted.
We saw that there were systems in place to protect people from harm. Staff had the skills and knowledge to raise any concerns they may have and the manager ensured that the appropriate authorities were notified.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes and hospitals. No applications had been made. Staff were alert to the signs of or potential for, abuse of vulnerable adults and procedures were in place, which were reviewed regularly to prevent abuse.
Is the service effective?
We saw that people were able to make choices about where they sat, what they ate and what they wore. We saw that people were supported to eat when required and helped to maintain independence where possible.
People’s care and health needs were assessed and planned for with the involvement of their relatives and professionals acting on their behalf if they were not able to express their opinions. This meant that people’s care was planned and delivered in line with their individual needs.
We saw that some interactions between the staff and people living in the home did not show that people’s dignity and respect was promoted.
The environment was generally safe and some refurbishments had been carried out since our inspection in May 2013. The appropriate adaptations were in place to support people to meet their needs.
We saw that some areas of the home were not clean and some equipment was not in working order. This could put people at risk of not having their needs met.
There were sufficient staff available and staff training was sufficient to meet all the needs of people using the service.
Is the service caring?
People we spoke with were happy with the care and support they received. Our observations showed that people were comfortable in the presence of staff. One person told us, “I bought my bed and curtains.” This showed that people were supported to make choices and be involved in decisions about their daily lives.
Staff generally responded to people’s needs in a caring and appropriate way ensuring that they were comforted. We saw that some interactions could be improved to ensure that people’s dignity was maintained.
People were supported to dress and have hair styles that reflected their individual personalities. We saw that people’s health needs were met. There was equipment available to meet people’s physical needs and activities organised to meet their social needs. For example, people were supported to maintain relationships that were important to them and attend church if they wanted. This showed that people’s diverse needs were met.
Relatives and health professionals who visited the home confirmed that care was provided in a personalised way.
Is the service responsive?
We saw that staff responded appropriately to people if they were upset. Care plans and risk assessment were reviewed regularly. We saw that health professionals were involved where people’s needs changed. One person we spoke with told us that another person that lived in the home sometimes shouted at them but the staff took the appropriate actions to protect and support them.
Activities were organised and planned. Activity plans should be reviewed on a regular basis to ensure that they remain appropriate and to introduce variety into people’s daily lives.
We saw that there were systems in place to raise concerns and that these were responded to in a timely manner. This meant that the service responded to concerns and addressed them appropriately.
We saw that some areas of the home had been refurbished and developed to meet people’s needs. We saw that some areas of the home, for example, en-suite facilities in people’s bedrooms were in need of cleaning and refurbishment. We were told that there was a plan in place for the refurbishment. However improvements were needed to ensure that all parts of the home was monitored to ensure all part of the home was kept clean.
Is the service well led?
There was a registered manager in post who was responsible for the day to day management of the home. Staff told us that they felt supported by the manager. Staff were supported to meet the needs of people through the provision of regular training, supervision and staff meetings that enabled good practice to be developed.
There was a system in place to monitor the quality of the service provided. We found that the information from some of the audits was out of date and there was little evidence of regular analysis of the audits undertaken.
We saw that some improvements could be made to the recording and monitoring of behaviours that challenged the staff.