14 September 2015
During a routine inspection
This inspection took place on 14 September 2015 and was unannounced. This meant the staff and the provider did not know we would be visiting. Four Ways Care Home was last inspected by CQC on 27 September 2013 and was compliant.
Four Ways is located in the town of Stanley, County Durham. The service comprises of three adjoining terraced houses each with their own distinctive design and layout. It provides residential care and can accommodate up to 13 people who have a learning disability. On the day of our inspection there were 12 people using the service.
The home had a registered manager in place. A registered manager is a person who has registered with CQC 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 service was in the process of changing registered provider.
People who used the service were complimentary about the standard of care at Four Ways Care Home and were asked about the quality of the service provided. We saw staff supporting and helping to maintain people’s independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.
We saw the home was clean and tidy with no unpleasant odours.
There were sufficient numbers of staff on duty in order to meet the needs of people using the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Training records were up to date and staff received supervisions and appraisals, which meant that staff were properly supported to provide care to people who used the service.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) is part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We discussed DoLS with the registered manager and looked at records. At the time of our inspection visit, DoLS were in place for people who required them however DoLS notifications had not been submitted to CQC. We discussed this with the registered manager and this was addressed on 17 September 2015.
We found evidence of mental capacity assessments or best interest decision making in the care records. Staff were following the Mental Capacity Act 2005 for people who lacked capacity to make particular decisions and the registered manager had made applications under the Mental Capacity Act Deprivation of Liberty Safeguards for people being restricted of their liberty.
People were protected against the risks associated with the unsafe use and management of medicines.
People had access to food and drink throughout the day and we saw staff supporting people at meal times when required.
People who used the service had access to a range of activities in the home and within the local community.
All the care records we looked at showed people’s needs were assessed before they moved into the home. Care plans and risk assessments were in place when required and daily records were up to date. Care plans were reviewed regularly.
We saw staff used assessment tools and kept clear records about how care was to be delivered and people who used the service had access to healthcare services and received ongoing healthcare support.
The layout of the buildings provided adequate space for people with walking aids or wheelchairs to mobilise safely around the home.