28 March 2017
During a routine inspection
At the last inspection on 8 October 2014, the service was rated Good. At this inspection, we found the service remained Good.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager had left the service at the time of the inspection. A new manager is in place at the service. They are employed by the registered provider managed the day to day operation of the service. The registered provider plans to submit an application to register a manager with the Care Quality Commission.
Staff continued keeping people safe from harm and abuse. Staff had training in safeguarding adults and showed they understood the ways in which people display signs of abuse. Staff told us how they would contact the local authority if they suspected an allegation of abuse.
Staff identified risks to people’s health and well being. When risks were identified, a plan of action was developed. This provided guidance on the risk and the actions staff would take to manage the risk. Staff used this process to continue to keep people safe from risks.
The registered provider maintained staff numbers that were sufficiently deployed on each shift. People continued to have their care and support needs met. Staff availability was flexible to meet the needs of people during the day and at night.
The management of people’s medicines continued to remain safe. Systems for the safe management of people’s medicines were embedded in the service. Staff practiced safe administration, storage, and disposal of medicines.
The registered provider continued supporting staff. There were embedded systems in place for appraisal, training, and supervision for staff. Staff had the opportunity to discuss their role, training needs and their professional development within the service.
People’s care continued to be delivered in line with the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff continued to seek people’s consent to care and treatment and respected their decisions. People remained supported by staff to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People’s nutritional needs were met and maintained by staff. Staff continued to prepare meals for people that reflected their cultural needs and preferences. Staff provided sufficient food and drink through the day to meet people’s needs and choices. Systems in place for people to access healthcare services were maintained by staff. The health care needs of people were met. People had access to health care services to meet their health care needs. Staff were aware of people’s health care needs and made referrals to care services when people’s needs changed.
Staff understood people well. Staff maintained a caring and respectful relationship with people. Staff were able to describe people’s likes and dislikes and how people wanted to receive their care. Records showed that staff continued to support people and their relatives in making decisions their care. Staff spoke with people in a way that showed they respected them and protected their dignity and privacy.
People continued to take part in a variety of social activities. Each person has a weekly plan that contained information about the activities they were taking part in. Relationships and friendships were maintained. People had the opportunity to remain in contact with people that mattered to them.
People and their relatives were continued to remained involved in an assessment of need. Following an assessment, a care plan is developed to ensure staff supported people to meet their needs. The care plans continued to be reviewed with people on a regular basis to ensure they remained relevant.
The complaint process was made available to people and their relatives. Complaints raised and continued to be investigated and a response provided to the complainant.
The manager maintained effective leadership to staff at the service. The manager was at the service each day and provided management support at the service.
Events that occurred at the service were reported to the Care Quality Commission as required. The service continued with the regular monitoring and review of the service. Audits of the quality of care were maintained. The manager developed an action plan to help make improvements to the service where necessary.
Further information is in the detailed findings below.