A person when asked about how staff treated them confirmed that, 'I am very happy here.' This meant that staff treated people with dignity. People knew that staff respected their wishes. People told us that staff asked them how they wanted their needs to be met. A person told us "Staff are helpful." This meant that staff listened to and responded to peoples needs. People felt that they could talk to staff about is how they wish to be supported.People told us that they liked the food. A person told us when asked about the food, 'I love their cooking.' People had meals that reflected their personal preferences and cultural backgrounds. People told us that they could discuss their concerns with the operational manager. A person commented that, 'I can talk to the manager if I have concerns.' Peoples' concerns were listened to an action was taken to maintain their well-being. People told us that the home was kept clean. A person when asked about this said, "The home is always clean." Infection control procedures make sure that people's safety was maintained. People told us they were happy with the way staff treated then. A person when asked about the staff said, 'The staff are good.' People were happy with the way staff treated them. Staff treated people with respect. People feel that they can trust staff to support them.
People were not aware of how they could be involved in making changes to their care. People said they had not been involved in reviews of their care. People were not consulted about how they would be supported. One person's care plan highlighted that they may at times be in pain. However, it did not give any indication as to what might show the person was in pain. We looked at the care plans and assessments relating to tissue viability care for a number of people. We found that assessments had not been completed in detail. Assessments and care plans need to provide the necessary guidance to ensure that people receive the care they need.
The care plans we looked at did not have clear guidance as to support the wishes of people regarding their end of life needs. People may not get the care they need at the end of their lives. One person whose care plan we looked at had dementia. The person's capacity assessment did not show how this would affect their ability to take decisions. We observed that staff did not show the way they worked that they understood how do respond to peoples' varying capacity.
We found that some medicines needed on a "when required" basis had not been reordered and there was no evidence that these had been stopped by the prescriber.
We found that here was not enough information for staff about some medicines being given to people. We found discrepancies in a few cases between records and medicines used. We found that the storage of some medicines was unsatisfactory and put people at risk of harm.
We saw that people were sitting at a table in the dining room/lounge for about twenty or so minutes without a member of staff. Many people spent too long on their own without staff being present. The home needs make sure that there are sufficient staff to care for people. A number of staff had completed their NVQ at levels 2 and 3. However, staff told us that they had not completed this training. Records confirmed that some staff had not been on this training. Staff need to have all the skills necessary to meet the needs of people. Most of the staff spoken to felt that they had not been supervised, guided or supported in their work with people. A member of staff told us, "Sometimes I feel I get support, sometimes not." There were no records of supervision to show that staff were getting the support they needed. Staff needs to be supported to provide the care that people need.