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Inspection report

Date of Inspection: 6, 7 August 2014
Date of Publication: 4 October 2014
Inspection Report published 04 October 2014 PDF


Inspection carried out on 6, 7 August 2014

During a routine inspection

Our inspection team was made up of two inspectors, and a specialist nurse.

We considered the findings of our inspection to answer questions we always ask:

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe at Holy Name. We observed interactions between staff and people who used the service that were respectful and friendly. People were relaxed in the company of staff.

People received their medicines as prescribed by their doctor and told us they received medicines in a timely way.

The manager sets the staff rotas and they made sure there was sufficient numbers of staff with the right skills and experience to meet people�s needs. They had recently reviewed and increased the number of staff at times during the day to provide more flexible staff deployment. We received some mixed comments from people about the staffing numbers. These included, �There seems to be enough staff on, I always get the help I need and they find time to sit and talk when they can� and �They are very busy at times and sometimes I have to wait when I ring the bell.�

We found the provider did not have clear systems in place to ensure the information they collected about incidents and accidents was analysed appropriately. This meant the information in audits was not always used to manage risks related to people who used the service.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring risks to the health, welfare and safety of the people who use the service are properly assessed and managed.

Is the service effective?

People were included in decisions about their care and the support they wanted. We found people�s care records overall reflected their preferences and choices.

We observed that there were good interactions between the staff and people, with friendly and supportive care practices being used to assist people in their daily lives.

Care files we checked confirmed that initial assessments had been carried out by staff before people moved into the service. This was to ensure the service was able to effectively meet the needs of the people. Specialist mobility and equipment needs had been identified in care plans where required.

People were offered meals that were varied and nutritious. Comments from people included, �We get lots of snacks� and �I have a lot of dietary requests; the cook comes to see me most days to discuss the menu and my preferences, they are very good about that.� A range of snacks and drinks were readily available and offered to people to ensure individuals received enough to eat and drink. People were assessed for the risk of becoming malnourished.

Records and discussions showed staff had received training, direction and support which enabled them to be more skilled and confident when supporting people, especially in relation to their dementia and health care needs. Gaps in the training programme were addressed during the visit, with courses in essential and service specific training arranged.

People we spoke with were complimentary about the staff and said they were kind and caring. Comments about the staff included, �Staff are kind to you�, �The staff are very kind and helpful� and �The staff are pretty good. Nothing is too much trouble. I feel settled here.�

Is the service caring?

We found that staff were understanding of people�s individual needs. People�s preferences, routines, likes and dislikes had been recorded and care and support was provided in accordance with people�s wishes and choices.

People were supported by kind and attentive staff. We saw that staff showed encouragement and patience when supporting people.

People who used the service told us they were happy living at Holy Name. Comments included, �Care staff are friendly, always popping in and making sure I�m alright� and �I�ve not been here long, but I do like the home. Staff and other residents are friendly.�

Is the service responsive?

Staff told us the care and support provided was flexible to the person�s needs and adjustments could be made where required. Care staff said they informed the nursing staff if they felt any change in needs was required and the support was reviewed.

The provider had considered the specific needs of people with a dementia related condition when planning improvements to the environment. They had recently moved the dementia unit from the first floor of the service to the ground floor so people with dementia could independently and safely access the garden area. The provider had used external consultants for advice on improving the environment for people with dementia and had implemented some of their guidance about use of colour to aid orientation. Further work to provide individual memory boxes was underway.

People had access to a range of health and social care professionals such as GPs, a psychiatrist, dieticians, speech and language therapists, social workers, dentists and opticians. There was evidence the staff team sought appropriate advice, support and guidance both routinely and during emergency situations.

People who used the service were happy with their health care. One person said, �They get the doctor when I�m poorly, they look after me very well, I am getting much better.�

Is the service well-led?

The service worked in partnership with key organisations, including the local authority and safeguarding teams, to support care provision and service development. Regular meetings were held with the intermediate care team to facilitate and support effective joint working arrangements.

We identified gaps with the systems in place to monitor the quality of service provided. Whilst some information about the service was gathered each month there needed to be more robust reviews, analysis and records about this information. This meant that shortfalls in the service were not always identified and action plans not produced to address them in a timely way.

There was a system of sending out surveys to people who used the service and their relatives; this had not been extended to the staff. The manager told us the issues identified in surveys had been addressed but this had not been recorded.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance.