Inspirations

Inspirations is a residential care home providing personal and nursing care to up to 16 people. The service provides support to older adults, some of who may be living with dementia and younger adults. At the time of our inspection there were 16 people using the service.

People’s experience of using this service and what we found

People were safeguarded from abuse by staff that understood how to recognise any concerns and take the required action to make people safe. Risks to people’s safety were assessed and staff followed plans to ensure these were minimised. There were enough safely recruited staff to support people. People had their medicines as prescribed and were protected from the risk of cross infection. Where incidents and accidents had happened there was action taken to prevent this from happening again and learning shared with staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received person centred care and were supported by staff who understood how to protect their rights. The registered manager had systems in place to monitor the service and understood their role and responsibilities. There were opportunities for people and relatives to engage with the service and share their experiences. Staff were supported in their role and were able to share their views about the service openly. The registered manager worked in partnership with other agencies and sought opportunities to learn and develop the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 09 May 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Inspirations on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

• People did not always receive their medicines as prescribed due to identified issues with medicines management systems not being fully resolved.

• People were protected from the risk of abuse, accident and injury. Where incidents arose, action was taken to ensure the safety of people within the service was continuously improved.

• People’s nutritional and health needs were met.

• People were encouraged to make choices and their rights were protected under the Mental Capacity Act 2005 (MCA).

• People were cared for by a staff team who had the skills to support them effectively. Care staff were kind and caring towards people.

• People’s privacy and dignity was respected and their independence promoted.

• People’s needs were assessed holistically and care staff worked to ensure both their physical health needs and emotional needs were met.

• People had access to a range of leisure opportunities and activites.

• People and staff felt they had a voice and that they were involved in the development of the service.

• People were supported by a motivated staff team who were committed to their roles and felt well supported by the registered manager and provider.

• The provider and registered manager were committed to addressing the concerns we identified and driving improvements within the service.

Rating at last inspection: At our last inspection the service was rated as ‘good’.

Why we inspected: This was a scheduled inspection based on the previous rating.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We have asked the provider to send an action plan outlining how they will make any required improvements. We will check at our next inspection to ensure these actions have been completed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service has a registered manager who was present throughout the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe living at the home. Staff were knowledgeable about their responsibilities to keep people safe and knew how to report any concerns they may have. There were sufficient, suitably recruited, staff available to meet people’s requests for support.

Staff had a good understanding of the Mental Capacity Act (2005) and could explain how they supported people in line with the principles of this legislation. People were given choices in all aspects of their care. Staff had received sufficient and specific training in order to meet people’s individual needs.

People received appropriate, timely support with their healthcare needs and were supported to maintain their nutritional and hydration needs. People were treated with dignity and respect.

People that we spoke with were happy with the care and support they were receiving and told us that staff were kind and caring. People and their relatives were involved in planning care that was centred around the person and their preferences. Staff spoke with affection about the people they supported and could describe people’s preferences for care.

There was opportunity for people to take part in activities if they wished to. The service had developed links with external groups who came into the home to provide activities based on people’s known interests.

Care was kept under review with people and relatives, when appropriate, to ensure care still met people’s needs. The service encouraged and supported people to maintain relationships with people that were important to them.

People and their relatives knew how to raise concerns and complaints and were given both informal and formal opportunities to do so. The service had ensured regular feedback was sought from people and their relatives to monitor people’s experience of the service provided.

People and their relatives told us that the service was well managed. The registered manager knew their responsibilities to the Care Quality Commission and had ensured systems were in place to continuously monitor the quality and safety of the service and seek feedback from people, relatives and staff. The registered manager kept updated on developments in the care sector and had sought guidance from external organisations to drive improvement. The registered provider had systems in place that ensured oversight of the service was gathered from external sources. Staff felt supported in their role, had regular supervisions and felt able to suggest improvements to service provision.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

The four people we spoke with told us they felt safe. Safeguarding procedures were in place and the three members of staff we spoke with understood how to safeguard people they supported.

We found that policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards were in place. At the time of our inspection no applications had been made. This meant that people would be safeguarded as required.

The four people we spoke with told us that they felt their rights and dignity were respected.

Systems were in place to make sure that the registered manager and staff learn from events such as accidents and incidents and complaints. This reduces the potential risks to people and helps the service to continually improve.

Risk management plans were up-to-date and staff said they received updates when people's needs changed. People were not put at unnecessary risk and were supported to make choices and remained in control of decisions about their care and lives.

We found that recruitment practice was safe and thorough. Policies and procedures were in place to make sure staff had information they needed so that unsafe practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them and their families where required. People were involved in making decisions about their plans of care. We saw that specialist dietary needs and physical health needs had been identified and met where required. The four people we spoke with told us they were involved in planning their care.

The registered manager told us that people were supported by their families and family involvement was encouraged at the home. We were told that people could be supported by an advocate if needed.

Is the service caring?

We spoke with four people who used the service, one visiting relative and a visiting district nurse. We asked them for their opinions about the staff that supported them. We received positive feedback from everybody we spoke with, for example; 'The staff are very good. They are very friendly' and: 'The staff are always good to me. I was poorly recently and they made sure I was alright'.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. We looked at examples of investigations which had been completed in line with the complaints policy. We saw that complaints were investigated and action taken as necessary.

People who used the service and their relatives completed regular surveys. We saw meeting minute that confirmed that people who used the service and their relatives took part in regular independent residents and relatives meetings to give feedback about the service. We saw that where shortfalls or concerns were raised these were dealt with.

The service worked well with other healthcare professionals and external agencies to make sure people received care in a coherent way. We found that the provider had worked in a co-ordinated way with other external agencies when a safeguarding allegation was reported to them.

Is the service well-led?

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.