6 June 2014
During a routine inspection
Some of the people who used this service were living with dementia and were not able to communicate easily with us. To enable us to assess people's wellbeing we spent time sitting with them in the lounge and dining area observing the care they received and the level of staff interaction with people. This is called a Short Observational Framework for Inspection (SOFI). This is a specific way of observing care to help us understand the experience of people who could not talk with us because of their dementia.
We also spoke with six people, the manager and three staff members. We looked at six people's care records and also looked at other records including health and safety checks.
During our inspection and through analysis of our inspection findings we considered the questions we always ask, is the service safe, effective, caring, responsive and well led?
This is a summary of what we found
Is the service safe?
We found that the service was safe. When we arrived our identification was checked and we were asked to sign the visitor's book. This showed that the staff took the security of the building and the safety of the people who lived there seriously.
When we spoke with people they told us they felt safe living in the service and that they would speak with the staff if they had concerns.
We saw that the staffing levels were based on the assessed needs of the people who used the service. There were enough qualified, skilled and experienced staff to meet people's needs.
The building was comfortable, clean and well maintained. We saw that the service had taken precautions to protect people from Infection and that staff had received appropriate infection control training.
We saw records which showed that health and safety checks were carried out in the service regularly and action was taken if equipment was found to be faulty or unsafe. This included regular visual checks and servicing of equipment such as hoists, the fire alarm panel and wheelchairs. Regular fire safety and legionella tests and checks were carried out, which showed that people were protected from unsafe or poorly maintained equipment.
We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), which was updated every year. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.
Is the service effective?
The people we spoke with told us that they were happy living in the service, one person told us, 'The staff are good to me.' Not all of the people were able to communicate with us easily, but during our observations of the care and support staff gave to people we saw that the service was effective in meeting people's needs.
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.
We saw that the service was effective in assessing people's nutritional needs and offered a good and varied menu, while ensuring that health needs and preferences were met.
Is the service caring?
We saw that the staff interacted with people who lived in the home in a caring, respectful and professional manner. Not all of the people were able to talk with us, but during the time we spent at the service we saw that people were comfortable, well dressed, looked smart and that staff were committed to caring for the people they supported.
The people we did speak with told us that they found the staff friendly and caring. One person told us, 'This is my home, and has been for the last two years.' Another person said, 'I get along alright here.'
People told us that the staff listened to their choices and treated them with respect. One person said, 'The staff are polite, but not so much they can't have a laugh and joke with me.' Another person told us that, 'It's OK here!'
The service provided meaningful activities and pastimes that were suited to people's personality and interests. We saw people taking part in a quiz that was held in a way that was inclusive of all the people who wanted to take part. Other activities were available in the service including birthday celebrations, church services and trips out.
Is the service responsive?
People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including the doctor, the speech and language team and the dietician.
The people who used the service and their relatives were given the opportunity to complete annual satisfaction questionnaires. The senior team leader said that the service responded to concerns raised with it through the survey. People and their families were also provided with the opportunity to participate in the running of the service by attending house meetings. The meeting notes showed that suggestions for improvement and issues that were highlighted as needing to be addressed were actioned and records were kept.
We saw that people's choices were taken into account and listened to in all aspects of the way the service was run. We saw that during dinner people were offered a variety of choices for their main meal and pudding. People were offered plenty to eat and given second helpings if they wanted more.
Is the service well led?
The service had an effective quality assurance system in place and the records we examined showed that identified shortfalls were addressed promptly. This would ensure that the quality of the service was maintained.
The staff we spoke with told us that the manager was supportive, easy to approach and listened to what they had to say. The manager told us that they felt supported by the providers.