5, 13 June 2014
During a routine inspection
The purpose of this inspection was to find out five key 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, seeking experience and views from people who used the service, their relatives, and 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?
People told us they felt safe. The home had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application for Deprivation of Liberty should be made, and how to submit on. However we did find the service had not reviewed people's care appropriately and where people had complex conditions they were not always cared for safely and effectively.
The service was not clean and hygienic, people did not receive medication safely and effectively. We have told the provider improvements are necessary.
Is the service effective?
People's health and welfare was not always protected and promoted although we do recognise the service had sought expertise and support from other health and social care services that people required, in order to meet their needs.
People did not always receive appropriate care and support because there were not effective systems in place to assess, plan, implement, monitor and evaluate people's needs.
Is the service caring?
Staff did not have a good awareness of individuals' needs and people were not treated in a dignified and respectful manner. We saw people did not receive care and support in a skilled way and staff were not always able to manage behaviours that were complex or challenging.
People were positive about their experiences. Comments included "They are all lovely and very kind". "I am very well looked after'. Many people using the service were not able to tell us their experience due to the cognitive difficulties they had, so we asked people's relatives to tell us about the service. Although some comments were positive such as "the staff work hard", "they do their best", Not all people we spoke with were positive. For example people expressed concerns there were limited activities, that people were not encouraged to be part of their community and people were not part of groups and clubs.
Is the service responsive?
Systems were in place to ensure where people required healthcare support they received it. However we found staff often lacked the skills to understand when it was necessary to obtain advice and guidance from health professionals which meant people did not always receive the care they required.
Is the service well-led?
The registered manager was on long term leave during our inspection due to employment issues. We found the management arrangements in the home to be inadequate and people may have been placed at risk of harm due to the lack of leadership in the service. It was evident the organisation was committed to ensuring people received care which was safe and effective but we did find shortfalls in auditing, care planning and staff attitude which meant people's needs were not always met in a safe and effective way. We told the manager and provider improvements were necessary.