We carried out this inspection to answer our five questions; 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 is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
The person was treated with respect and dignity and we observed caring and compassionate care by the staff. The person had their own care file and these contained person centred information for example 'how I communicate with you' and 'how you communicate with me'. This was in pictorial format and also included Makaton signs relating to feelings, dislikes and likes. This contained information about the way each person should be supported and cared for. Additional information included risk assessments to ensure the person remained safe from harm.
There were activities for the person to be involved in to give them stimulation and a choice about their welfare for example shopping, swimming, visits to the seaside, music, visiting the caf' and a weekly stay at a relative's house and a shopping day.
We saw that the service had appropriate controls in place for the safeguarding of the person. Records we looked at included personalised plans to ensure the person who used the service was appropriately safeguarded. Records included for example plans for neglect, institutional abuse, physical abuse, and emotional abuse.
The service and communal areas were pleasant, clean and hygienic. All areas of the property were free from clutter and obstructions which meant that the person was protected from trip hazards and self-harm. The overall building maintenance was kept to a generally high standard.
Is the service effective?
We reviewed records for incidents and accidents and found that they were appropriately recorded and acted on. However, we found four records not to be dated. We spoke to the manager about this and they assured us that they would update these records immediately. Staff we spoke with were clear about the incident process and the procedure for recording when incidents occurred.
Visiting relatives told us, 'Staff listen to our views and they ask us a lot of questions and we get a lot of input with XXX's support. Staff even contact us to ask if they can get XXX a new jumper or cut her hair.'
Is the service caring?
The person's care was planned and delivered in a way that was intended to ensure their safety and welfare. We saw that the person had risk assessments in place. These were up to date and covered areas such as: behaviour which challenged, being out in the community, mealtimes, personal care, bathing and travelling in the car.
We spoke with visiting relatives of the person that used the service and they told us, 'The staff here are absolutely superb. They have offered for us to come to tea with XXX. We have not done this yet, but we will soon' and 'XXX's mobility was quite bad before she came here but now she is even walking on her own. We have seen three things improve over the last few months which are mobility, nutrition and handling her behaviour. We are very confident that the staff know how to handle XXX's behaviour and we are so pleased XXX is here.'
Is the service responsive?
We observed positive interactions between staff and the person living in the home. We saw that staff offered the person choices in how care was to be delivered and that they took their time to explain care tasks to the person. We saw that the person was encouraged and supported to maintain their independence where they were able to.
Records we looked at confirmed that the head office on behalf of all its services had sent out a quality performance survey to all of the people who used the service, their relatives and other healthcare professionals. We saw that 35 surveys were sent out in November 2013. Records we looked at showed that the provider had monitored the survey returns of; three from healthcare professionals, two from social care, eight from relatives and three from people who used the service.
Is the service well-led?
The service had an effective quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.
Records we looked at included a monthly check of the persons care plan for the purposes of accuracy for example; diary notes, behaviour monitoring charts, bowel chart, body maps and support plans. Following the evaluation the monthly check was signed by the team leader.
The staff we spoke with knew about their involvement with team meetings and supervisors and the manager observing their care activity. This meant that staff were confident and clear about their roles and their responsibilities. Staff told us, 'We have staff meetings every month to discuss any issues about the service but we also have a key worker meeting to discuss more person centred things. The meetings are really useful to resolve any potential issues that may be arising and they always get resolved quickly.'