A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?Below is a summary of what we found. The summary describes what the relatives of people using the service and the staff told us, what we observed and the records we looked at.
When we visited we met five of the seven people who lived at the home. They were not able to tell us about their experience of living at the home due to their communication and special needs. We observed people being supported by the care staff.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
Risks to people had been identified, assessed and kept under review. Staff had the skills and knowledge to know how to meet people's needs and keep them safe. They had undertaken training including fire safety, how to respond positively to people's behaviours and manage people's health conditions.
Procedures were in place to ensure people who lacked mental capacity had decisions made for them that were in their best interest.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one. Restrictions were in place to help keep people safe. The home was working closely with funding authorities to ensure any restrictions were correctly authorised under the DoLS. This meant that decisions were made by a multidisciplinary team which helped protect the vulnerable people using the service.
The registered manager had made appropriate safeguarding referrals to the local authority. They and the provider reviewed all accidents and incidents.
There were well developed systems to make sure health and safety risks within the home were minimised.
Is the service effective?
We found that people's on-going needs were regularly assessed and the care and support provided for them was well planned and purposeful. People had benefitted from this and developed new skills or taken part in new activities that had enhanced their lives. One person's relative told us they were very satisfied with the care provided to their family member. They said, 'I have visited unannounced and have no criticisms about the personal and physical care' and 'They are getting X (person's name) to be as independent as possible'.
Changes in how the care was provided were discussed with people when possible and their relatives, the staff and professionals involved in their care. Behaviour monitoring records were kept up to date and accurate. This provided reliable information to staff and professionals to ensure the support provided met people's current care needs.
There were systems in place to ensure the staffing arrangements met people's needs. Each person had staff assigned to them each day. Activities were planned ahead based on what people enjoyed, so staff knew what to offer people. Each person had their own activities planned for the day we visited. Staff discussed people's needs during their shift to ensure that there was a continuity of the care provided. Staff meetings and supervision sessions were held regularly and staff were expected to attend training and gain qualifications. This meant that staff were well trained and skilled in their work.
Is the service caring?
We observed that the staff worked calmly and were well organised. They smiled and engaged with people in a natural and caring way. The atmosphere was relaxed and homely.
One person's relative told us, 'X (person's name) interacts well with the staff and the transition has gone amazingly well' and 'I can tell they are happy' and 'The staff are open to ideas and I feel part of it'.
Staff discussed what people enjoyed and shared ideas of activities to try. Decisions were made in people's best interest after consultation with their relatives and professionals.
We saw that staff did not rush people and they encouraged them to make choices and gave them time to make their decision. Discussions and observation showed that staff knew people's preferred routines, likes and dislikes well.
Is the service responsive?
We found that the management team were open to feedback. Ideas were listened to and used continually to try to improve outcomes for people living in the home.
The service worked in close cooperation with people's relatives and others involved in people's lives to help ensure the best outcomes for people. Concerns were listened to and taken seriously.
The service had responded positively to people's behaviours that had an impact on the environment and been creative with finding solutions so people's freedom was not restricted unnecessarily.
Staff felt that their views were listened to and any concerns were taken seriously.
Is the service well led?
We found that there were good care outcomes for people living at the home. The team were committed to giving people enjoyable lives and new opportunities.
One person's relative told us, 'I have a good relationship with the manager and feel I can raise any issues'.
Staff told us that they felt part of a good team and that they were well supported. They said the registered manager listened to any issues and took action quickly when needed.
The service operated in an open way and welcomed the involvement of people's relatives and other professionals. People's relatives had confidence in the service and felt they could give their ideas and views.
We found the management team were committed to continually improving the service and outcomes for people living at the home. There were well developed quality assurance systems and risks to people's safety were kept under close review.