During our inspection we looked at the way people were cared for and supported, how people were safeguarded from abuse, cleanliness and infection control, the way staff were supported to carry out their duties and the quality monitoring systems in place. We spoke individually with a four people living at the home, two relatives, the registered manager, the general manager, the care and training coordinator, the housekeeper, a senior carer and a care worker. Care practices were also observed for a short period, during the course of the inspection. This helped to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found.
Is the service safe?
People were treated with respect and dignity by the staff team. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.
Systems were in place to make sure that the management and staff team learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one.
The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.
Is the service effective?
There was an advocacy service available if people needed it. This meant that when required, people could access additional support.
People told us that they were pleased with the level of care that was being delivered to them and that their assessed needs were being met. From our observations and through speaking with staff it was clear that there was a good understanding of each person's assessed needs and that personal preferences were accommodated. One person told us, 'This is a jolly good place to live'. Another person said, 'I am quite happy here. You get every attention they cannot do enough for us'.
Health and care needs had been assessed and people had been involved, as far as they wished, or were able, in writing their plans of care. Although some people spoken with were unsure about their current care plan, they were unconcerned by this. On the care plans we looked at, each had been signed by the person or a close relative, to confirm their understanding and agreement to the content.
The relatives we spoke with confirmed that that were able to see people in private and at a time of their choice. These people were also very positive in their comments regarding the care provided at Cove House and confirmed that they had good communication with the staff team.
Is the service caring?
People were supported by kind, caring and attentive staff. We saw that care staff showed humour, patience and gave encouragement when supporting people. One relative, when asked what the service did well, commented, 'The overall care, compassion and kindness shown to people'. Another relative said, 'They (the staff) always go the extra mile'. A person living at the home said, 'It is a very nice place to be. They (the staff) do quite a lot really and they are all very, very kind'. A member of staff added, 'Cove House is homely. We try to make it home from home, do activities and outings. The care we give is I think, very good. It is good enough for my family, for my dad.
People using the service and their relatives and friends had been given opportunity to complete satisfaction questionnaires. This, along with the regular resident meetings and open general meetings, helped people to formally have their say and influence change.
Health and care needs had been assessed and people had been involved, as far as they wished, or were able, in writing their plans of care. Although some people spoken with were unsure about their current care plan, they were unconcerned by this. On the care plans we looked at, each had been signed by the person or a close relative, to confirm their understanding and agreement to the content.
Is the service responsive?
The people we spoke with said they were very satisfied with the arrangements in place to support social activities and social interactions. Social care needs had been given high priority. However it was also acknowledged that some people preferred spending time alone in their bedroom and this was respected.
People said that they knew how to make a complaint if they were unhappy about anything. Although formal complaints were infrequent, documents were available to record the complaint, the name of the person making the complaint, the process of investigation and the outcome. We saw that there was an 'open door' policy with people expressing their views, or queries as they arose. This meant that any concern or query could be dealt with immediately. People living at the home and the relatives we spoke with confirmed this to be the case.
Is the service well led?
The service worked well with a range of health professionals to make sure that people received their care in a joined up way. Records were kept of all health professionals visits in respect of each person, which included the reason for the visit and the outcome.
Staff told us that they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance processes in place. This helped to ensure that people received a consistent service at all times.
Staff also told us that they felt very well supported by the registered manager, general manager and the wider Abbeyfield Silverdale and District Society organisation. We were also told that the staff team worked well together for the benefit of the people living at the home. We saw that the staff team was stable meaning that people living at the home were cared for and supported by staff who knew them well.
A wide range of routine audits and internal quality control measures were in place including structured overall monitoring of the service by the Trustees. This helped to ensure that a consistent service was maintained that helped to protect people and keep them safe.