An adult social care inspector carried out this inspection in response to information that had been shared with us by the local authority. The focus of the inspection was to answer four key questions; is the service safe, effective, caring and responsive? As part of this inspection we spoke with two people about their care and the service they received. We spoke with three other people who use the service whose comments did not relate to the standards we were talking about but who looked relaxed and spoke to us happily about other things. We also spoke to four relatives, six members of staff and the company representative. We reviewed seven people's care records. We also reviewed the service's complaints records and policy, staffs' professional development records and the service's training records.
In this report the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. We have advised the provider of what they need to do to remove the individual's name from our register.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
Is the service safe?
People were safe because staff had been given information about people's needs and how to manage them. Information about people's risks had been recorded, shared with staff and plans had been made to manage these. For example, specialised equipment had been introduced when people were at risk of falls, people at risk of losing weight received fortified foods and drinks. Risks associated with pressure ulcer development were managed.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. People were safe because the service had proper policies and procedures in place in relation to this. Where people were deprived of their liberty in order to keep them safe this had been done lawfully. The manager was aware of the amendments (March 2014) to the DoLS legislation and had started to take action in response to this. Staff had received training in relation to DoLS and senior staff knew how to make a DoLS referral if required.
Is the service effective?
The service was effective because people received care that met their individual needs, choices and preferences. Care plans sometimes lacked personalisation but gave staff basic guidance on how to meet the person's needs.
The service was effective because staff received training relevant to their role. They also received on-going support with their professional development. Where needed there were arrangements in place to address shortfalls in staff performance and to remind staff of their responsibilities.
The service was effective because it delivered care with people's consent and where consent could not be given, in people's best interests.
Is the service caring?
The service was caring because we observed people being treated with respect and dignity. Arrangements were in place to preserve people's privacy. We did not observe any situations where a person's dignity or privacy was compromised.
The service was caring because care was delivered in a thoughtful and kind manner. One person who uses the service said, "They are all wonderful". Another person said "I can have a joke with them (the staff) that is so important to me".
The service was caring because they listened to and involved people's relatives in their care.
Is the service responsive?
The service was responsive because it responded to people's altering needs.
The service was responsive because they recognised people's diversity. A good example of this was seen in the kitchen where a person's religious beliefs were respected. A "clean area" had been established in order to prepare one person's food without contamination from other certain foods.
The service was responsive because it sought additional support or intervention when needed. Referrals were made to health care professionals when needed and advice followed. One relative said '"I think it's probably as good as you are going to get, it's not always perfect, but they understand (relative's name)".
The service was responsive because action had been taken in response to people's concerns and complaints.