The inspection was carried out in order to answer five key questions; is the service safe, effective, caring, responsive and 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?
When we last inspected the service in February 2014 we found that it was not safe. We asked for improvements to be made. We found that people were at risk because the provider had not made sufficient checks in relation to the suitability of job applicants.
In February 2014 we found that people were at risk of receiving care from staff who did not have the skills to meet their needs. On this inspection we saw records which confirmed that the provider had ensured that all staff had received the training they required to support people safely.
In February 2014 we found that people were at risk of not receiving their medicines safely as prescribed. The provider had not assessed the competency of staff to safely support people with their medicines before they undertook this task on their own. On this visit we saw records confirming that all staff in the service had received training in the safe administration of medicines and an assessment report had been completed in relation to their competence in this area. Records showed that staff had supported people to receive all their medicines correctly at the right time of day. People received their medicines safely as prescribed.
At this inspection we confirmed that the provider had improved staff recruitment arrangements and all the required checks on staff had been undertaken before they started work. People were protected from the risk of receiving care from unsuitable staff. People told us that they trusted the staff and felt safe. People and their relatives told us there were sufficient staff on duty to meet people's needs. People received a consistent and safe level of support.
We saw evidence that the provider had undertaken the appropriate checks in relation to managing risks to people's health and safety. For example, audits were carried out on various aspects of the service, including stocks of medication, fire safety arrangements and the maintenance of the building.
The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). We confirmed that the service met legal requirements in relation to DoLS and there were no unauthorised deprivations of people's liberty.
Is the service effective?
People's needs had been assessed and they had an individual support plan which set out how the service supported them. People told us they received their support in the way they wished. Support plans promoted people's independence by specifying what tasks they could carry out independently. People received their support in accordance with these plans. The service had ensured people had seen a range of health care professionals for specialist care and treatment.
People told us that staff were skilled and knew how to care for them well. The provider had ensured staff had received relevant training in topics such as supporting people with mental health needs and managing challenging behaviour.
Is the service caring?
People were supported by kind and attentive staff. A person's relative said, 'I visit [my relative] regularly and know all the staff. They are friendly and treat people well.' Staff knew about people's individual background, interests and preferences and used this information when communicating with people and offering support.
Is the service responsive?
People told us they were asked how they would like to be supported. A relative who acted on behalf of a person who uses the service said they were fully involved in planning the person's support so that it reflected their interests and preferences. People using the service told us that they were asked about their views and these were taken into account in relation to the delivery of their support.
People went out of the service to a range of activities of their choice and followed their own interests. People were supported to retain links with their family. A person's relative told us, "I come here often and the staff always make me welcome and tell me what has been happening."
Is the service well-led?
The current manager of the home has been in post since 16 May 2014 and is not yet registered with the Care Quality Commission. Staff, people who use the service and relatives who act on their behalf told us that the manager communicated well with them and they had confidence in him. Improvements had been made in relation to record keeping and staff recruitment. Staff had received appropriate training and support. The provider had worked in cooperation with the local authority to analyse incidents and to identify improvements to the service.