This inspection was carried out by one inspector. We spoke with ten people who used the service and observed their experiences of care to support our inspection. Not everyone we met could express themselves verbally due to their health condition. We spoke with the registered manager, eight staff, one healthcare professional and five relatives. We considered our inspection findings to answer questions we always ask:-
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well-led?
Below is a summary of what we found.
Is the service safe?
There were concerns with the management of medication, including administration and recording.
We saw that people had received an assessment of their needs before moving into the home to ensure that staff were able to safely meet the person's care and support requirements.
We found call bells were being answered promptly by staff.
There was no person in the home subject to an authorisation made under the Deprivation of Liberty Safeguards (DoLS) at the time of inspection. Staff had received training, so they knew how to safeguard people at risk of abuse and we saw best interest decisions had been made to protect people from harm.
The provider had emergency procedures in place to keep people safe from harm, including fire evacuation procedures.
Is the service effective?
Staff had received adequate training to meet the needs of the people who lived at the home.
We had a mixed response from relatives that we spoke with. Some told us they were happy with the care being delivered and their relative's needs were met, while others were less positive. One relative also told us, 'I can go on holiday with no worries and know they are being looked after properly.' Another relative told us they wanted to see more activities, particularly exercise to help their relative.
We saw people had a choice of where they ate meals and what they had. Meals were found to be nutritious and in adequate quantities. Refreshments were available throughout the day. One person said, 'Staff are very accommodating when it comes to serving meals.'
Reviews to make sure people's needs had not changed were not always carried out. In these cases this did not ensure staff supplied the correct amount of care and support.
There was evidence learning from incidents or accidents took place and appropriate changes were implemented.
Is the service caring?
Observations during the visit showed staff being attentive to the people they were supporting. We found positive interactions taking place and people were comfortable and relaxed with the staff that supported them. We saw staff responding in a kind manner to the people who lived at the home.
The home held regular meetings for the people who lived at the home to share their views and for the home to respond to any issues raised. We were told yearly surveys were also completed to further collect the views of the people living at the home and
People who lived at the home were escorted to hospital by staff if the need arose, which meant that people were supported by a familiar face.
Is the service responsive?
We could see from care records, that when a person's needs changed appropriate actions were taken to ensure that needs were met, including for example; arranging for people to see a GP.
We saw staff quickly responding to requests from people who wanted help.
We saw only limited activities taking place for the majority of people who lived at the home on the day of the inspection, although we saw a wider range of activities were available on other days.
One relative told us that staff contact them to update them on any changes to the health of their relative or any other information that they may need to know about.
We found that complaints were listened to and actions taken to respond. We saw evidence of this during the inspection.
Is the service well-led?
There was a registered manager in post at the home. The home also had a deputy manager to support the registered manager.
All of the people, who lived at the home, and their relatives that we spoke with, knew who to contact if they had a problem. One person who lived at the home said, 'I have never had cause to complain.'