10 May 2019
During a routine inspection
People’s experience of using this service:
The provider had not met the characteristics of ‘Good’ in all areas. This has meant the overall rating for this service is ‘Requires Improvement’. We have identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We have also made a recommendation about how the provider can improve how the principles of the Mental Capacity Act 2005 are implemented in people’s care. More information about this is in the full report and can also be found at www.cqc.org.uk
The risks to people’s health and safety were not always appropriately assessed to reduce those risks. This included some risks in relation pressure care, medicines and safe evacuation. People’s medicines were managed and administered safely; however, robust protocols were not always in place for the administration of ‘as needed’ medicines. People felt safe when staff supported them in their home. People were protected by staff who understood how to protect them from avoidable harm. There were enough staff in place to respond to people’s needs and to keep them safe. The risk of the spread of inspection was safely managed. Systems were in place to help the provider to learn from mistakes, accidents or incidents.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service did not always support this practice. People’s health was monitored by staff, but this was not always reflected in robust and comprehensively completed records. People were supported to maintain good nutritional health; however, there was limited guidance in place for the monitoring of the diets of people who had diabetes. Staff felt supported to carry out their role effectively and had received training deemed mandatory by the provider for their role. People had access to other health and social care agencies where needed.
People found the staff to be kind, caring and respectful. People were treated with dignity and their independence was encouraged. People felt able to discuss there needs with staff. People’s records were stored securely to protect their privacy.
There was an inconsistent approach to the way people’s personal preferences and choices were considered when care was planned for them. It was not always evident that decisions made for people were in accordance with their preferences. People’s needs were assessed prior to them using the service. Some people received support with rehabilitation with the aim of returning to fully independent living. People had access to information in a format they could understand. Complaints were responded to in line with the provider’s complaints policy. People were not currently receiving end of life care.
Quality assurance processes were not always effective in identifying, monitoring and acting on any risks to people’s safety. There was limited involvement of the provider in ensuring the registered manager was carrying out their role effectively. This meant there was limited focus on continued learning, development and improvement. The registered manager had a good understanding of the regulatory requirements of their role. Some people were unaware who the registered manager was; however, those that did, felt they acted on any concerns they raised. Staff felt able to raise any concerns and the registered manager would act on them. The handover process at times was limited in recorded detail about the care people had received.
Rating at last inspection:
This was the service’s first inspection under its current registration.
Why we inspected:
This was a planned inspection.
Follow up:
We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern we may inspect sooner than scheduled.