During our visit, we spoke with five of the thirteen people who used the service. They shared some of their experiences at the home. We spoke with two care workers, the manager and the deputy manager, one family member and a visiting district nurse.One inspector carried out the inspection. 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 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 saw people were being cared for in an environment that was safe and clean.
The people we spoke with who used the service told us they felt safe. One person said 'They always want to help you.'
We saw training records and certificates which showed staff had received training to enable them to meet the needs of the people who used the service. This meant the provider could demonstrate the staff employed to work at the home had the skills and experience needed to support the people living there.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005 (MCA). The aim is to make sure people in care homes and hospitals are looked after in a way which does not restrict their freedom inappropriately. There were no authorisations restricting the freedom of anyone living at the home at the time we visited. Several members of staff had received training about the Mental Capacity Act and Deprivation of Liberty Safeguards so they understood when an application should be made and how to submit one.
Although members of staff had received training in the management of medication we saw one handwritten medication administration record was not countersigned. There was no evidence of any medication errors but a lack of clear records increased the risk of mistakes being made.
We saw quality assurance questionnaires had been circulated to professional visitors. One had commented 'I would be happy to place vulnerable people here.'
Is the service effective?
People's health, social and care needs were assessed with them or their relatives and they were involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. Care plans were reviewed regularly every month.
From the training records we viewed we found staff had received training to enable them to meet the needs of the people who used the service. Discussion with staff and examination of records confirmed a programme of training was in place so all members of staff were kept up to date with current practice.
The people we spoke with told us they were happy with the care they received and said their needs were met. They spoke positively about the care they received and the staff who supported them. From what we saw and from speaking with staff it was clear they had a good understanding of the care and support needs of the people who used the service.
Is the service caring?
People we spoke with told us they liked living at the home. Comments included 'They are always asking if you're satisfied or if you want any changes' and 'Staff listen when I have concerns.'
Feedback we saw in a thank you card from a family member said 'Your care was outstanding, particularly during her final days.'
We saw the staff showed patience and gave encouragement when they were supporting people so people were able to do things at their own pace and were not rushed.
Is the service responsive?
People's needs had been assessed before they moved into the home. The records we saw confirmed people's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People had access to activities which were important to them and had been supported to maintain relationships with their friends and relatives.
We saw people's rooms were spacious, light and clean. People had personalised their rooms with their belongings and furniture. There was a dining area and a lounge and a conservatory was used as a separate 'quiet' area. All of these were clean, spacious and light. The gardens were large but were mainly concrete. We were told there were plans to lay lawns to make the garden more inviting. There were ramped entrances for easy access.
Is the service well-led?
We saw documentary evidence that the service worked well with other agencies and services to make sure people received their care in a joined up way.
From speaking with staff we found they had a good understanding of the home's values. They told us about their roles and responsibilities and they were clear about these. We saw quality assurance processes were in place to make sure the provider monitored the care provided and made improvements where necessary. For example, satisfaction questionnaires had been completed by people who used the service and their families and by professional visitors. We were told the results would be analysed and a report produced although we did not see this.