We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, 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?
Staff demonstrated an understanding of the support required to enable people with dementia to make choices about their daily care. The registered manager had recently been informed that the pharmacy, which supplied people with their medicines and staff with an electronic medicine recording system, had ceased trading. The registered manager and staff took swift action to ensure people living at the home continued to receive a supply of medicine in a safe way. However, we found that there were several medication errors during our inspection visit and this put people at risk of developing a health related condition. This meant there was a breach of the Health and Social Care Act regulations. A compliance action has been set and the provider must tell us how they plan to improve.
People received an assessment of their needs in order to identify any areas of risk in delivering their care. Staff reviewed most people's risk assessments to ensure any changes to people's health and well-being were identified promptly. However, we found that some people at high risk of developing health conditions did not always receive care as indicated in their care plan records. People did not always receive a re-assessment of their needs following a stay in hospital to ensure their care needs could be met by the service. This meant there was a breach of the Health and Social Care Act regulations. A compliance action has been set and the provider must tell us how they plan to improve.
Is the service effective?
People's health and care needs were assessed with them, and they and their family members were involved in writing their plans of care. There was a system of staff training and supervision in place to ensure staff were sufficiently supported to do their jobs.
People and their relatives told us that overall they were happy with the level of care provided. We observed people were relaxed and happy in their environment. We observed some people enjoyed the company of other people in the living areas. One person said 'There are a range of activities here, and we have bingo, scrabble, cards and people come to sing to us'. They told us that they enjoyed a wide range of activities on offer at the home. We observed that people had access to a well maintained and safe garden and they were observed sitting in the garden and enjoying the good weather.
People's records including monitoring charts for food and fluids, re-positioning charts and medication administration records (MAR) were not always stored appropriately. This made it difficult to find information to ensure people had received good care. This meant there was a breach of the Health and Social Care Act regulations. A compliance action has been set and the provider must tell us how they plan to improve.
Is the service caring?
People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People told us that they were happy living at Victoria House. One person said 'I like it here, I have a comfortable bed and my bathroom is clean'. They also told us 'There is a beautiful garden, and the staff are nice, they help me to get dressed and are really caring people'.
The home had two resident cats and we observed that this helped to create a homely environment which people enjoyed. One person said 'I love the cats; it's more like being at home'. A relative of a person who used the service told us that they were 'impressed' with their family member's care and they had been encouraged by staff to come and join their family member for lunch, which they had enjoyed.
Is the service responsive?
Staff had responded appropriately to a range of medical needs and we saw that medical professionals such as the G.P, district nurse and dietician were regularly involved in people's care. We also observed staff working in the kitchen area and saw that they prepared fresh meals and a range of desserts for people using the service. Staff told us that they catered for a range of diverse needs and this included having a 'kosher' menu for people of Jewish origin.
We observed people who were seated in a communal living area during the afternoon of our visit were assisted by staff, and provided with sufficient amounts of refreshments such as tea, coffee, soft drinks sandwiches and cakes.
Is the service well-led?
The service had a quality assurance system to gain regular feedback from people who used services and to monitor the quality of service provided. However, we found that some identified improvements were not always acted upon. This meant there was a breach of the Health and Social Care Act regulations. A compliance action has been set and the provider must tell us how they plan to improve.
The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff stated that the registered manager expected high standards of care at the service. However, a few staff told us that the registered manager did not always walk around the home to spot check the quality of service delivered.