20 August 2014
During a routine inspection
During the inspection we looked at respecting and involving people who use the service, care and welfare, safeguarding, requirements relating to workers and quality assurance.
This is a summary of what we found, using evidence obtained via observations, speaking with staff, speaking with people who used the service and their families, and looking at records:
Is the service caring?
We saw staff offering support to people in a respectful manner. We looked at care records and saw they included evidence of people's personal choices and preferences, individual support needs and appropriate risk assessments.
There was evidence within the care files that people's rights were balanced with the risks to them to ensure they were cared for in the least restrictive way. Activities were provided and people were actively encouraged to socialise to help maintain their mental and physical well-being. People who did not wish to socialise had their rights respected, but efforts were made by staff to ensure they did not become isolated or depressed.
We spoke with four people who used the service and one visitor. The visitor told us, 'It's fantastic here. All the staff are very, very helpful. The place is spotless'. Comments from people who used the service included, 'I'm happy enough', 'The staff are absolutely first class, we have parties, it's brilliant', 'I feel safe here. Staff are really nice, if you want something you can just press your buzzer and they'll come', and, 'I'm quite happy here, you know someone is around'.
Is the service responsive?
People received an assessment of need prior to moving in to the service. We saw that people's mental capacity was taken into consideration with regard to decision making and care was taken to ensure decisions were made in the person's best interests. Some staff had undertaken MCA training and those we spoke with demonstrated a good understanding of the principles of the Mental Capacity Act (2005).
Staff had attended dementia care training as well as bespoke training for other specific conditions that people who used the service may have. This assisted them to offer the correct level of support and help to everyone who used the service.
The opinions of people who used the service and their relatives were sought via a number of methods, such as regular questionnaires, comments forms and informal discussions. We saw that suggestions, such as those made via the last questionnaire, had been responded to by the service.
Is the service safe?
Risk assessments were in place in the care records. These risk assessments were reviewed and updated regularly to ensure people's needs were met safely.
Each person who used the service had a personal emergency evacuation plan (PEEP) to facilitate the safest possible evacuation in the event of an emergency. Environmental and health and safety checks were carried out regularly to help ensure people's safety.
Staff training was thorough and up to date and refresher training was undertaken regularly to help maintain skills and keep knowledge current.
Staff had received safeguarding training and demonstrated a good knowledge and understanding of safeguarding. Policies and guidance were in place and accessible to staff. Safeguarding concerns had been reported and followed up appropriately to help ensure people's safety within the service.
Staff were recruited safely as the service had measures in place to ensure they were entitled to work in this country, references were taken up and Disclosure and Barring Service (DBS) checks undertaken. A thorough induction process was undertaken prior to employees commencing independent working.
People who used the service with whom we spoke told us they felt safe in their homes.
Is the service effective?
We spoke with five staff members who demonstrated a good understanding of their roles and responsibilities.
Feedback from questionnaires and comments forms indicated a high level of satisfaction.
We spoke with four people who used the service and one visitor. All felt the service was of a good standard and met their needs effectively. The visitor told us their relative's well-being had improved significantly since they had moved in to the unit. They told us, 'With everyone's help and support it is working'.
Is the service well-led?
There was a registered manager in place who was appropriately registered with CQC.
The quality assurance systems in evidence demonstrated a significant amount of monitoring, analysis and response to any shortfalls identified. The initiation of the Quality Circle Group was felt by the unit managers to be positive. They told us focusing in depth on a particular theme at each session enabled meaningful discussion, debate and problem solving to take place.
Staff meetings and individual supervisions were held on a regular basis to discuss a range of issues and topics.
People were encouraged to speak with staff or the manager of the service to raise any issues or concerns. There was a robust complaints procedure in place within the service.