We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found:
Is the service safe?
We found the service to be safe because they had a range of policies and procedures in place to protect the people who lived in the home. The staff we spoke with had a good understanding about how to report any concerns.
We observed that staff were competent and professional in their interactions with people who lived at the home. During our inspection we observed people were relaxed and appeared very content with the care and support provided.
We observed staff assisting people to transfer to/from wheelchairs with the aid of a hoist. We saw people were assisted in a safe and dignified manner. Staff took time to explain what they were going to do and offered constant reassurance to the people they were assisting. People appeared relaxed and comfortable when being assisted.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While 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.
Care and treatment was planned and delivered in a way that ensured people's safety and welfare. Care plans included a range of individual risk assessments and agreed actions for managing these risks. These included reducing the risk of falls, skin damage and malnutrition.
Staff received appropriate levels of support which enabled them to care for people safely and to an appropriate standard.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We saw that all medicines had been stored securely and had only been administered by registered nurses.
Is the service effective?
We found the service to be effective because people's care treatment and support achieved good outcomes. We also found that people's rights and choices were respected by staff.
We saw staff recorded information about each person on a daily basis. Information included how people had spent their day and how they had responded to activities of daily living. This meant the effectiveness of people's care plans could be fully reviewed.
We saw that people's prescribed medicines had been regularly reviewed by their GP or specialist health care professional. This meant that people received medicines which were appropriate to their needs.
Is the service caring?
Staff interacted with people in a gentle and kind manner. The people we spoke with were very complimentary about the care they received and the staff who supported them. Comments included 'I am so satisfied with everything. Honestly, things couldn't be any better' and 'I have nothing to grumble about. All the staff are very nice and kind.' The visitors we spoke with told us 'The care and attention couldn't be better. I visit most days and all I see is kindness' and 'Everyone is so friendly and welcoming. I have no complaints at all.'
The staff we spoke with had a very good understanding about the needs and preferences of the people they supported. They understood and responded to people's needs and requests where individuals were unable to make their wishes known verbally. This demonstrated that staff knew people well.
Is the service responsive?
The service was responsive to people's needs. We observed people were supported in accordance with their needs. For example we saw people were provided with soft diets and nutritional supplements where required.
People told us they did not have to wait long when they used their call bell to summon assistance. Throughout our visit we saw staff responded to call bells in a timely manner. The maximum time someone waited was five minutes.
The staff we spoke with were very knowledgeable about the needs and preferences of the people they supported. They knew about the things which were important to people. For example what drinks people preferred and how strong they like their coffee and how and where people preferred to spend their day.
We observed staff offering people choices throughout our visit and saw they responded promptly to any requests. The people we spoke with made the following comments 'the staff know me very well. They know I prefer to stay in my room. They respect that and they pop in regularly to see I am alright' and 'the staff know that I am frightened to go in the hoist so I don't like to have a bath. I prefer a bed bath and that's what I get. They are so lovely.'
Information about people's health needs and contact with health and social care professionals had been recorded. One person told us 'they are very good here. If you need the doctor, they get the doctor. No questions. Another person said 'I have no doubt at all that they would call the doctor if I wasn't well.'
Is the service well led?
The service was well led because there were systems in place which monitored the quality of the service provided. A manager was in post who had recently been registered by us. The manager was supported by a deputy manager and an administrator. We saw that registered nurses and senior staff were always available to support less experienced staff.
We asked staff what it was like working at the home. Some of the staff we spoke with had worked at the home for many years and some under a year. They made the following comments 'I am very happy here. There is really good team work and I feel we are able to give people really good care' and 'I love it here. I wouldn't want to work anywhere else. It's a great team and the support is really good.' We asked people who lived at the home and visitors for their views. They made the following comments 'the staff are wonderful. They couldn't be more caring if they tried' and 'there always seem to be plenty of staff about.'
People who lived in the home and their representatives were provided with opportunities to express a view about the quality of the service provided. Information about meeting dates for people's representatives had been clearly displayed in the reception area of the home.
We found procedures were in place to minimise any risks to the people who lived at the home. Regular internal audits had been carried out which monitored the on-going health and safety of people. Internal audits included checks on the home's fire systems, environment, care planning and the management of people's medicines.
We saw that staff had the opportunity to attend regular staff meetings. We looked at the minutes from a recent meeting. These showed that a range of topics had been discussed which included policies and procedures, staffing and information about the people they supported.