During this inspection we spoke with nine people who use the service, two visiting relatives, 14 members of staff, the manager and a senior manager. We observed support being given and looked at care and treatment records for 14 people who use the service. 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?
This is a summary of what we found '
Is the service safe?
We found that care and support records were not all up to date, accurate and fit for purpose. There were some inconsistencies in the way that care and treatment was recorded, which meant that people were at risk of receiving unsafe or inappropriate care and treatment. Senior staff had started to audit the care plans on both the residential and nursing units and had identified areas which required improvement.
People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Risks associated with the provision of care and support had been assessed, such as in relation to mobility and falls, nutrition and weight. Any concerns were followed up and appropriate action was taken. This meant that care was planned and delivered in a way that was intended to ensure people's safety and welfare.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw records demonstrating that proper policies and procedures were in place and these were adhered to. The manager understood when an application should be made and how to submit one; and was aware of recent changes to the legislation.
Is the service effective?
The service was effective in supporting people to be able to eat and drink sufficient amounts to meet their needs. We saw kitchen and care staff had a list of people who required special diets, such as vegetarian, diabetic, soft, pureed or fortified meals. There was no choice of food on the menu. However, when the food arrived if the person did not want it then alternatives were offered, such as toast, sandwiches or fruit.
A training programme was in place, which showed staff were provided with training and relevant qualifications to support them in meeting people's needs. The staff we spoke with said they felt the training was relevant to their work and helped them to meet the current needs of people using the service. Staff confirmed that they had supervision meetings in which they could discuss any matters relating to their work.
Is the service caring?
We observed that staff interacted with people who use the service and knew their likes and dislikes. This helped to create a friendly, caring and supportive atmosphere in the home. A relative told us 'My Mum is so happy here, she has been happy from the moment she walked through the door. The staff are marvellous and look after her really well'.
All of the people we spoke with in the residential unit told us they felt safe and happy living in the home. One person said 'This is a lovely to place to live, I am happy here'. Another person commented 'The staff are really, really wonderful, they look after us well and I feel safe living here'. Another person told us 'I sleep like a log here, I feel so safe'. People we spoke with in the nursing unit also commented positively about the care they received. One person said 'It's a wonderful home. They are so kind. They can't do enough for you'.
Staff demonstrated positive attitudes to their work. For example, one care worker said 'This is a lovely home, we work as a team and all help each other. The resident is the most important'. An agency member of staff we spoke with told us 'This is a very happy home. I love it here. I feel part of the team'.
Is the service responsive?
People's health needs were monitored and referred to health professionals appropriately. We observed that staff assisted people in a way that was sensitive and responsive to their changing needs. One person told us 'They are so good here. I had a hospital appointment today. The staff got me up early and got my breakfast for 7 am. We don't usually get it until 9 am but they did that just for me'.
Another person who uses the service told us staff 'See the need before you ask'. A relative told us 'There has never been any problem. They would phone me if need be'.
A system was in place to monitor and respond to any concerns or complaints about the service. We saw a copy of a letter written in response to a person's complaint, which showed the management had taken the complaint seriously and taken appropriate action.
Is the service well led?
The service was well led. We saw that regular audits of the quality and safety of the service took place and were recorded. In addition to these, a services manager for the organisation carried out regular checks that were also recorded. There was an on-going improvement log completed by the manager, which was a record of actions taken in relation to audits, incidents, and feedback from people using the service or others acting on their behalf.
A person who uses the service said 'We have no complaints. If I did I would talk to the boss. You could talk to her about anything; she is so calm and lovely'. Another person also told us 'You can talk to the manager about anything'. We observed that the manager knew the names of people who use the service and had a good rapport with them.