On the day of our inspection there were 42 people using the service. We considered all the evidence we had gathered during our inspection 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?
Is the service safe?
People were cared for safely. People's needs were assessed and reflected in their care records. Risk assessments were in place and reviewed regularly. We asked people if they felt safe. One person told us, 'I definitely feel safe. Staff are caring and kind.' One relative told us, 'My relative is safe, happy and well cared for.'
Accurate and appropriate records were maintained. All personal records were kept in a lockable cupboard. Care records we looked at were accurate and up to date.
Arrangements were in place for obtaining and disposing of medicines safely. Medicines were delivered to the home monthly. Most medication was dispensed in a Monitored Dosage System (MDS). Where medication was not in the Monitored Dosage System (MDS) it was clearly labelled with all relevant information. Medicines were stored safely in locked medication trolleys and in locked cupboards. Care workers who administered medication had been trained. Medication Administration Records were accurate and completed appropriately. This meant that medicines were managed safely.
CQC monitors the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager had made application for a Deprivation of Liberty Safeguard (DoLS) showing us that relevant staff understood when an application should be made and how to submit an application. This meant there were suitable policies and procedures in place.
Is the service effective?
People received support that was effective. People received support and care that kept them emotionally and physically well. Staff showed clear understanding of individual needs and supported people with empathy. People's changing needs were addressed in a timely manner and referrals made to health professionals where needed. Care records for people living with dementia had information about their past and staff recognised the importance of knowing this. People moving into the home and their families were supported through the process. One relative told us, "I came in and had breakfast every day when my relative moved in to help them settle."
People using the service had an individual care plan which set out their care needs. People had their needs assessed and were involved in the development of their care plan. Family and friends were involved in care planning where it was appropriate. One relative told us, 'I am very involved. It is a care partnership.'We saw that care staff had a clear understanding of people's care and support needs. One member of care staff told us, 'I love getting to know everyone.'
Care staff working in the home were well supported. Care staff records showed care staff had received training to meet the needs of the people living in the home. One care staff member told us, 'We have great team work. I wasn't very confident but the support has helped me.' Care staff received formal support four times a year, which included one to one supervision, appraisals, staff meetings and spot checks.
Is the service caring?
People were supported by a caring service. People we spoke with were happy with the care and support they received. One person told us, 'I'm quite happy. It couldn't be better.' During our visit we spent some time in the lounge conducting a SOFI. We saw people were engaged in activities or tasks and had good interactions with care staff. We observed care staff being kind and considerate. One care staff member spent time with a person who was anxious about a relative who was unwell. The care staff member was reassuring, showing empathy and understanding. Arrangements were being made for the person to visit their relative in hospital.
Is the service responsive?
People benefited from a service that was responsive. Care records showed people's religious beliefs and identified spiritual needs. There were monthly religious services held in the home. The home had involved an interpreter to support decision making for a person whose first language was not English. This meant that individual needs were met.
During our visit we saw people engaged in activities. Care staff were supportive, they encouraged and praised people who were joining in. The atmosphere was calm and relaxed. People we spoke with told us there were different activities most days. We were told that visitors come in from the community and support activities. One person told us, 'I like karaoke on a Thursday.' Care staff told us this was a popular activity.
Is the service well-led?
People received a service that was well-led. The manager was clearly passionate about the care and support of the people living in the home. Care workers spoke positively about the manager and the staff team. Care workers told us they were confident to raise concerns and that they would be taken seriously.
We looked at the quality assurance systems that were in place. There was evidence that information was reviewed and used to improve the service. People's views were listened to and action taken. The service was monitored on a consistent basis to ensure that people's care and treatment was safe and appropriate to their needs.
Records we looked at were completed accurately and were regularly reviewed. This meant that records were fit for purpose