This inspection was carried out by one inspector. We met everyone who lived at Shortwood House. One person was cared for in bed. There were 11 people living at the home at the time of our visit. We observed care being provided but were not able to speak with everyone. We spoke with four people who used the service and asked them about their experience of living at Shortwood House. We also examined care plans and other records. We spoke with the provider, manager and three care staff working at the service.We last inspected this service on 30 July 2013. At that time we found the service had a complaints system in place. However comments and complaints people made were not always responded to appropriately. At this inspection we found the service had introduced a complaints log which recorded concerns and how these were resolved. We used the evidence we collected during our inspection to answer five questions. A summary of what we found is set out below.
Is the service safe?
We spoke with one person who told us, 'This is a lovely place. I was so afraid I wouldn't find anywhere I would feel safe. We are beautifully looked after."
The service protected people who were unable to make decisions, for example, about their finances. The service used Deprivation of Liberty Safeguards which are a legal framework designed to ensure that the care people receive does not unlawfully deprive them of their liberty. The process followed by the service met the requirements of the Mental Capacity Act 2005. There were no Deprivation Of Liberty Safeguards (DoLS) in place at the time of our inspection. The home had obtained a DoLS authorisation for a person who had recently moved to another service. The person tried to leave the building but was unaware of the risks, because of their condition.
We found contracts were in place for maintaining fire detection systems and the lift which enabled people to reach the first floor of the home. The home's central heating service was regularly inspected by a service engineer. We saw they had raised a concern about the safety of the system which had not been resolved. We did not see a risk assessment had been carried out.
Is the service effective?
We looked at four people's care plans and found their needs had been assessed. This included identifying risk, for example, of falling or developing pressures sores. Daily records recorded how the service supported people at risk, for example, by re-positioning the person every two hours. We found care plans and risk assessments were reviewed. The manager had a schedule of care plan reviews which showed when the reviews were planned or had taken place.
One person required a special diet because their condition meant they could not eat food containing gluten. Guidance for staff was available in the kitchen and in the person's care plan.
Care plans showed the service had discussed people's wishes for the end of life and plans had been agreed with relatives about the person's preferred place of death.
Is the service responsive?
One person told us, 'I have had my hair done and I feel so much better." We asked one person how long staff took to respond to the call assistance alarm. They said, 'Staff are pretty good at responding."
We spoke with the provider who told us they were a dignity champion for the service. They described how they were part of a national organisation which promoted dignity in care homes.
Is the service caring?
The manager told us the service was providing support for a married couple. One partner had lived in another home. When a place became available the manager arranged for the person to join their partner. One person we spoke with told us, 'I have been feeling really low recently. Staff take me out for a few hours and it takes my mind off things.' We saw care staff comfort and reassure the person when they were upset.
Care staff we spoke with told us they had time to care for people, for example, by talking to them as well as carrying out caring tasks.
Is the service well led?
The owner had developed a quality assurance process which consisted of audits and checks designed to identify and manage the risks to people 's health and welfare. The service had also obtained feedback from people who used the service, relatives and staff.
Care staff were supported with training and supervision from their manager. We saw the manager discussed people's knowledge about supporting people, for example with dementia, as part of care staff supervision meetings.
There were systems in place for identifying and managing risk but we found examples of risks which were not being managed effectively.