15 March 2018
During a routine inspection
There was a registered manager in place who was taking planned extended leave at the time of inspection. The two service managers were responsible for the running of the service in their absence. 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 provider’s management team were practically involved in the day to day running of the service. They were on hand to provide guidance to staff and regularly worked alongside them to offer support and monitor their working behaviours and performance.
Risks to individuals associated with their health and wellbeing were assessed and monitored. People had plans in place to support staff to help people manage their anxieties and escalating behaviour. When incidents took place, the provider took appropriate action to investigate, report and follow up concerns, putting plans in place to minimise the risk of reoccurrence.
There were sufficient staff to meet people’s needs. The provider had systems in place when recruiting candidates to ensure that only suitable staff were employed to work with people. There were currently some vacancies for permanent staff and the provider used agency staff to ensure there were enough staff to meet people’s needs. People, relatives and social workers told us that permanent staff were skilled, but not all agency staff were as familiar with people’s needs.
Staff had received training which was sufficient to meet people’s needs. Where the provider had identified that staff required additional training in specialist areas such as communication, they had taken action to ensure staff received access to these skills. The provider monitored staff’s ongoing work performance through supervision and observation of their work practice.
People’s care needs were assessed by the service in partnership with funding authorities, people and families. The provider was proactive in reviewing people’s care by making appropriate referrals to healthcare professionals when people’s needs changed. When people transitioned to and from different services, the provider had a clear insight into the benefits of putting robust plans to help reduce people’s anxieties about upcoming change.
People received personalised care. People’s care plans detailed information about people’s health, life history, wellbeing and preferred routines. The provider was committed to ensuring that people were supported to be as independent as possible. Staff were caring in their role and treated people with dignity and respect.
People were encouraged to access healthcare services when required. The level of support people required around eating and drinking was identified in people’s care plans. People had been supported to make referrals to healthcare professionals in order to meet their dietary requirements and staff encouraged people to follow recommendations given. There were systems in place to support people to manage their medicines. The provider had made improvements to its medicines management system, which had resulted in a significant reduction in medicines errors that had occurred.
People were supported 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 were involved in making decisions about their care and were supported to be part of their local communities. There was mixed feedback about how the provider communicated with people’s relatives. The provider had identified the challenges to improve and had plans in place to improve its communication strategies with everyone involved in people’s care. There were appropriate systems to manage complaints and concerns. The provider helped to ensure people were satisfied with the outcome of investigations of concerns by writing to them about their findings.
The provider had systems in place to monitor the safety and quality of care. They had implemented improvement plans which were regularly reviewed to track the progress of the service and identify where additional improvements were needed.
The provider worked in partnership with other stakeholders to help assess, monitor and improve the quality and safety of the service.