Our inspection team was made up of one inspector who answered our five questions. Below is a summary of what we found. The summary is based on our conversations with the manager, three staff, one person who used the service, two relatives and from looking at records. Where it was not possible to communicate with people who used the service we used our observations to gather information.Is the service safe?
People were cared for in an environment that was safe, clean and hygienic. The appropriate recruitment checks had been completed prior to staff being employed. Staff had received appropriate training and guidance. Records contained detailed assessments of people's needs that had been carried out prior to them moving to the service. This ensured that the staff had the relevant skills and knowledge required to meet the individual's identified needs.
Where people did not have the mental capacity to provide consent the provider complied with the requirements of the Mental Capacity Act 2005. Staff had received training in this area. The Care Quality Commission monitors the operation of the Deprivation of Liberty
Safeguards which applies to care homes. Whilst no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.
The provider had clear policies and procedures regarding medication, we saw that medication was stored, administered and disposed of in line with their policies and procedures. Staff received annual refresher training. The provider carried out regular audits of medication.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. One person
said, "The staff are excellent they couldn't do anything any better.'
Is the service effective?
It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew the people well. Relatives we spoke with told us that, "The staff are very knowledgeable about my relative's needs." People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified in care plans where required. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
The training that staff had received equipped them to meet the needs of the people who used the service.
Is the service caring?
People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. One relative said, "The staff worked well with my relative they always ask her how she wants things done.'
Is the service responsive?
Where people's care needs had changed appropriate referrals to the doctor, district nurse, dentist had been made and any recommendations had been acted on.
The manager had regular contact with the relatives of people who used the service. Both relatives told us that the communication between them and the staff was good. Where shortfalls or concerns were raised these were addressed promptly.
Is the service well led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. A district nurse told us, "The manager and staff are very good they follow the advice they are giving and they also provide very clear and detailed information when making referrals to us.'
The service had a quality assurance system in place. Records seen by us showed that identified shortfalls 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 and that they received excellent support and supervision from the manager. Staff had a good understanding of the ethos of the service. This helped to ensure that people received a good quality service at all times.