The focus of the inspection was to answer our five key questions:Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
As part of this inspection we spoke with the one person who used the service, a relative of a person who used the service, the manager and two care workers. We also reviewed records relating to the management of the home which included, three care records including care plans, daily care records, risk assessments. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us that they felt their rights and dignity were respected. They told us they felt safe. Systems were in place to make sure that managers and staff learnt from events such as complaints, concerns, whistleblowing and investigations. There was sign posting information available to people who used the service to share their experience and to access independent support and advice. This reduced the risks to people and helped the service to continually improve.
We observed members of the staff team supporting people in a respectful and supportive manner. We observed one member of staff offering reassurance to a person who was becoming agitated about wanting to go home.
We looked at the training matrix for the staff team. This record showed the provider actively supported the staff team to undertake training to enable them to provide safe and appropriate care and support. This record also showed that staff received training around safeguarding vulnerable adults from abuse. We spoke with two members of staff who described how they would ensure the welfare of vulnerable adults was protected through the whistle blowing and safeguarding procedures. The manager was also very clear about his responsibilities in this area. We spoke with the relative of a person using the service they told us, 'I am so impressed with how the staff team care for mum and how patient they are, I have no concerns about how mum is treated or cared for. If I felt I had any concerns I would go to the care staff on duty and if I did not feel my concern was addressed I would speak to Mark (Registered Manager).'
People's health and care needs were assessed with appropriate referrals being made to external professionals who were able to assess and support the care of people in the home. We looked at the care records of the three our people using the service. We found that not all the care plans, risk assessments and management plans reflected their current needs and recorded the support people required or wanted. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to keeping accurate records and appropriate information in relation to the care and treatment provided to each person staying at the service.
Is the service effective?
People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well
Care needs such as mobility and healthcare needs had been identified in initial assessment documents. However, risk assessments and care plans we saw did not clearly show how these identified needs were to be met. Care plans were therefore not able to support staff consistently to meet people's needs.
Is the service caring?
People were supported by kind and attentive staff. One relative of a person using the service told us, 'this place is like a home from home, mum is very settled here it's a shame she can't live here permanently, the staff are so respectful and kind the entire focus of the service is about the person they are caring for.'
Is the service responsive?
Discussions with members of the staff team indicated that a detailed induction programme was in place to ensure the staff team had the necessary skills and competencies to meet people's needs.
The training matrix showed the provider supported staff to undertake training to support them in their roles. For example the training matrix for 2013/2014 showed the following training was to be provided to the staff team; understanding dementia, Mental Capacity Act and the Deprivation of Liberty Safeguards, break away training and emergency first aid. Members of the staff team spoken with told us, 'Age UK really invest in staff training I feel valued by this and feel people who use our service receive better and safer care because of it.' If a person comes to stay with a health or behavioural issue we have not had experience of supporting the manager sorts out some training, recently we had Parkinson's Disease training. I feel supported by the manager and the teams I work with I really enjoy my job.'
Discussions with the manager and information held on the staffing rota indicated that staff from the day service and the homecare service work in the respite service as well. The manager told us this cross over working supported people who use the respite service as they had already built relationships with members of the staff team.
We saw that care workers showed patience and gave encouragement when supporting people. Some of the records we looked at did not show people's preferences, interests and preferred routines. Other records we looked at were not as detailed as they could be.
Is the service well-led?
There was a Registered Manager in post at the time of our inspection. The service worked with other agencies and services to make sure people received their care and support in a joined up way.
The service encouraged people who used the service, their relatives and carers to complete a questionnaire at the end of their stay this survey is called 'Are we getting it right we want to hear from you'. We looked at six completed surveys that provided positive feedback for the service. The provider, Age UK also carried out an organisational survey on an annual basis to gain the views of the people who used their services and to adapt services to meet people's changing needs and expectations.
The quality assurance systems in place were informal with no documented formal feedback provided to the manager from audits carried out by senior managers within the organisation.
Records showed the service had not reviewed and updated the health and safety assessments to reflect the current building work being carried out at Meadowcroft.