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Inspection report

Date of Inspection: 13, 14 August 2014
Date of Publication: 27 September 2014
Inspection Report published 27 September 2014 PDF

Overview

Inspection carried out on 13, 14 August 2014

During a routine inspection

At the time of our inspection there were 46 people living at the home. During our visit we spoke with ten people who used the service and we observed the care they received. We spoke with three members of the care staff team, and two healthcare professionals involved with the care of some people at the home. In addition, we also spoke with five people's relatives to establish their opinion of the service.

We considered all the evidence we had gathered under the regulations we inspected. We used the information to answer the five 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?

This is a summary of what we found.

Is the service caring?

We saw that people were supported by kind and attentive staff who displayed patience and gave encouragement when supporting people, for example when assisting them with mobility. People appeared content and looked well cared for. Our observations confirmed that generally most people were very independent and staff encouraged this, whilst ensuring that they offered assistance to people if they required help. People told us that they were happy with the care and support they received from the service. One person said, "You get to know them (staff) here, they help you. The staff are always nice."

Staff were fully aware of people's care and support needs. Staff told us, and people confirmed that they pursued activities both inside the home regularly and within the community. On the day of our visit a small group of people enjoyed an outing to the beach for fish and chips. This showed the provider promoted people's well-being.

Is the service responsive?

The provider had arrangements in place to review people's care records regularly and we saw that amendments were made to people's documentation as their needs changed, to ensure this remained accurate and any issues were promptly addressed.

Staff told us, and records showed that where people required input into their care from external healthcare professionals, such as district nurses or doctors they received this care. One visiting GP told us, "I don't have any concerns here. If anything they phone me a lot. I have not seen anything that concerns me when I have come here."

People had a wide variety of foods available to them and confirmed that they were given choices. People's weights and food and fluid intakes were monitored if needed and referrals had been made to dieticians where necessary, to ensure they received specialist input into their care to remain healthy.

Is the service safe?

People told us they felt safe and the care that we observed was delivered safely. Risks that people may be exposed to in their daily lives and in relation to their care needs had been considered. We saw that instructions had been drafted for staff to follow to ensure people remained as safe as possible in light of these identified risks.

We reviewed the procedures that the provider had in place for safeguarding vulnerable adults and found that these were appropriate. Staff were trained in safeguarding and were fully informed of their own personal responsibility to report any incidences of harm, abuse or suspected abuse.

We reviewed the arrangements in place for the management of medicines. We found that these arrangements were not appropriate as controlled drugs were not effectively managed and individual stocks of medicines did not always tally with what had been received and administered. We have set a compliance action and we have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the management of medicines.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We discussed the recent Supreme Court judgement handed down on 19 March 2014 in the case of 'P v Cheshire West and Chester Council and another' and 'P and Q v Surrey County Council', about what constitutes a deprivation of liberty. The regional manager advised us that they were aware of this ruling, and had already liaised with their local authority safeguarding team for advice on their responsibilities and the arrangements they now need to put in place, for people in their care.

Is the service effective?

People told us they were happy with the staff who cared for them and they met their needs. One person said, "Staff are always nice, I have nothing against the staff." Another person told us, "Staff are lovely." It was evident from speaking with staff and through our own observations that staff had a good knowledge of the people they cared for and their needs.

Staff told us that they felt supported by the manager and the provider, although supervisions did not happen very often. We discussed this with the regional manager who advised that a new system is currently being introduced to address this.

Is the service well-led?

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities 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. A newly registered manager was appointed and in place. Staff said they felt supported by her and people and relatives that we spoke with felt the service was managed effectively.

The provider had policies and procedures in place which gave direction and instruction to staff.

Meetings for staff, people and their relatives were held regularly. Audits related to medication, care planning, health and safety and infection control were carried out to identify any issues or concerns. We saw that the provider had drafted action plans where issues needed to be addressed, in order to ensure that the service remained effective and well led.