28 December 2017
During a routine inspection
There was a registered manager in post who was also the registered provider. 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.
The provider also managed another service, which had recently been inspected and rated as 'inadequate'. Many of the issues found at the other service had been highlighted as a cause for concern at this service. However, these concerns had been partially mitigated due to the employment of a new management team who were responsible for the day to day running of the service. This factor together with input from the local authority had resulted in improved systems and processes. Consequently, many improvements had already been made and others were planned.
People, staff and relatives were positive about the new management structure and reported progression in the quality and effectiveness of the service. Staff morale had improved and there was a sense of teamwork and a commitment to providing a good service. People's feedback regarding the quality of the service was actively sought and was used constructively to make improvements.
There were sufficient staff employed to meet people's needs. Care staff were not rushed and had time to spend with people. Staff were usually on time for calls and there were no reports of missed visits. However, recruitment processes for care staff required strengthening to ensure staff were recruited safely.
Staff had received training to support people to take their medicines. Improvements were required to ensure more robust assessment and monitoring of staff competence to ensure staff had the skills and knowledge to safely manage people's medicines.
People and their relatives said they felt safe using the service. All staff had completed safeguarding training and there were systems and processes in place to respond to incidents or allegations of abuse.
People had risk assessments in place, which provided detailed guidance to staff on how to minimise risk. Accidents and incidents were recorded by staff and shared with the management team who took the appropriate action to minimise the risks of reoccurrence.
The service provided staff with an induction and training, and supported staff through observations and supervision of their practice to support staff with their learning and development. At the time of inspection staff had yet to receive annual appraisals of their performance however, these had been scheduled for 2018.
People's consent was sought before care and support was provided. Staff and the management team were aware of the requirements of the Mental Capacity Act 2005 (MCA). Assessments of people's capacity and best interest decisions were made appropriately, in consultation with relevant parties.
The service supported people to have enough to eat and drink and helped people to access healthcare services if needed.
Staff were caring, courteous and respectful of people's privacy and dignity. People were listened to and included in decisions about how they would like their care and support delivered. Independence was supported and encouraged.
Improvements had been made to the quality of information held in people's care records. This meant that staff had access to more detailed guidance to enable them to provide care and support that was tailored to each individual and met their needs and preferences.
There were policies and procedures in place for managing complaints. People knew how to complain though lacked awareness about who the registered manager was. People were familiar with the care manager and care supervisor and knew how to contact them to raise any concerns. Records showed that complaints were dealt with appropriately.