One the day of our inspection we talked with the manager and looked in detail at the records for three people. We observed how people were being cared for and talked with two people who lived there. We visited on a weekday and all three people were at home. We talked with one staff member and health professional. We also spoke with two relatives. One relative commented, 'The care is quite good actually, there's a lot of one to one time with the staff.'We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found;
Is the service safe?
People had been cared for in an environment that was safe, clean and hygienic. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. People told us they felt safe. Safeguarding procedures were robust and staff understood their role in safeguarding the people they supported.
The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been made in accordance with these safeguards, proper policies and procedures were in place, and the manager understood their responsibilities in relation to the law.
There were policies and procedures in place to make sure that unsafe practice is identified and people are protected. This included the correct administration of medication. The staff and manager had a good understanding of whistle blowing policy.
Is the service effective?
People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well. Some people had certain dietary needs that staff supported them with, enabling people to make informed choices. This included taking people to the shops and supporting them to buy food of their choice.
We found that the home was very person centred and all staff were aware of peoples choices, preferences and support needs. Care plans had been written to reflect this but needed to be updated. One professional told us 'The people are provided with a very homely service there.'
Is the service caring?
People were supported by kind and attentive staff. We saw that the staff and manager showed patience and gave encouragement when supporting people. One relative told us 'I think the home is fine, my (relative) likes it there". A professional told us "The manager is very happy to advocate on behalf of people when they are in hospital, they are very caring. They make sure we have all the up to date information about the persons health needs on the ward.'
Is the service responsive?
People's needs had been assessed before they moved into the home. People told us they had a lot of one to one time with the staff. People had access to activities that were important to them, and staff were aware that people's wishes and choices changed regularly. We observed staff supporting these changes. People had been supported to maintain relationships with their friends and relatives. One relative told us 'If there's a problem, they phone me straight away.'
Is the service well-led?
Staff told us they were clear about their roles and responsibilities. The service worked well with other agencies and services to make sure people received their care safely and effectively.
A professional told us 'It's a very positive working relationship.' The service has a basic quality assurance system and they use their community meetings and handover meetings to assure the quality of service delivery to people.