Background to this inspection
Updated
5 April 2016
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 was 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 took place on 2 February 2016 and was unannounced.
The inspection team consisted of two inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We looked at information we held about the service. This included information received from commissioners of the service and notifications. A notification is information about important events which the provider is required to send us by law.
We spoke with four people who used the service, four relatives and a healthcare professional. Not everyone who used the service was able to talk with us about their experiences so we spent time observing how care and support was offered to people in communal areas.
We spoke with nine members of care staff, the registered manager and the deputy manager. We looked at six people's care records to see if they were accurate and up to date. We also looked at records in relation to the management of the service. These included quality checks, two staff recruitment files and other documents to help us to see how care was being delivered, monitored and maintained.
Updated
5 April 2016
This inspection took place on 2 February 2016 and was unannounced.
The service was registered to provide accommodation and nursing care for up to 85 people. People who used the service tended to be over 65 years old and had physical and/or mental health diagnoses. There were five units at the service. These included a residential unit for people without nursing care needs, a nursing unit, a unit for older people with mental health needs and two single gender units for people with behaviours that challenge. At the time of our inspection 68 people were using the service.
We carried out an unannounced comprehensive inspection of this service on 2 and 3 September 2015. Breaches of legal requirements were found. After the comprehensive inspection, we asked the provider to take action to make improvements to meet legal requirements in relation to protecting people from harm and abuse, providing safe care and treatment, staffing levels, meeting nutritional and hydration needs and assessing and monitoring the quality of the service provided. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements.
The service had a registered manager. 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 were at risk of receiving inconsistent care because risk management plans were not always in place or not clear.
People were encouraged to make their own decisions and support was provided in line with current legislation and guidance. However, not all staff understood the legal requirements of the Mental Capacity Act (2005) which meant there was a risk that people's legal and human rights may not be respected.
People had access to healthcare professionals, though records did not always consistently show that health needs were monitored and what actions had been taken when required.
People were mostly treated with kindness and compassion though there were examples were staff did not approach people in a caring manner.
We saw that improvements had been made to the systems in place to monitor quality and that the registered manager took actions to make improvements when required. However, there were some issues that had not been identified during quality checks.
People felt safe and were protected from avoidable harm and abuse by staff who knew how to recognise potential signs of abuse and how to report them appropriately. We saw that systems were in place and were followed to ensure that safeguarding adult’s investigations took place when required.
There were enough staff to meet the needs of people who used the service and staff were recruited safely. People's medicines were managed safely so that they received them as required.
People were provided with enough food and drink to maintain a healthy diet. People had choices about their food and drinks and were provided with support when required to ensure their nutritional needs were met.
People were provided with personalised care to meet their needs and preferences. Care plans included life history information and staff knew people's preferences. People's dignity was respected and they were encouraged to be involved in developing their care plans.
People knew how to complain if they needed to. A complaints procedure was in place and we saw that complaints had been dealt with in line with the provider’s procedure. People and their relatives were encouraged to give feedback on the care provided via questionnaires and meetings. The registered manager responded to feedback and changes were made to improve the quality of the service provided.
People, relatives and staff felt the registered manager was approachable and responsive. The registered manager understood the requirements of their registration with us.