Archived: Polonia

Polonia provides residential care and mixed accommodation for older people predominantly from the Polish or other eastern European communities. The home has 9 beds and is situated across two floors.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People told us they felt safe and very well looked after at the home and overall there were enough staff to meet their needs. We saw the home was clean, tidy and homely and decorated and furnished to meet the cultural needs of the people who used the service. There were systems in place to safeguard people who used the service and to ensure people were protected from abuse. Staff knew how to report any suspicions of abuse or poor practice.

We found systems in place did not fully ensure people who used the service received their medication as prescribed at all times.

Risk assessments had been completed but were not always supported by clear risk management plans to show how risks were reduced or prevented. People’s care plans were not always personalised or provided detailed information on how care needs were to be met.

People’s care records did not demonstrate people had been supported to make best interest decisions in accordance with the Mental Capacity Act 2005 and there was a risk people were deprived of their liberty without authorisation as applications for the Deprivation of Liberty Safeguards had not been considered for people whose liberty may be deprived.

People received timely access to healthcare; a range of other professionals were involved to help make sure people stayed healthy. People’s nutritonal and hydration needs were met very well.

Overall, staff were trained and supported to do their job well. However, the provider’s policy did not specify the frequency of refresher training and this could lead to staff’s practice becoming out of date.

People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. There was opportunity for people to be involved in a range of activities that met their social and cultural needs. People enjoyed the activity on offer at the home and were supported to maintain contacts with friends and family.

Systems of quality assurance were in place to monitor whether the service was providing high quality care. However, these were not always formal which could lead to potential risks being overlooked.

We identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the registered provider to take at the end of this report.

Nine people were living at the home when we visited. As part of this inspection we spoke with the three people using the service, a carer and the registered manager. We also reviewed records relating to the management of the home which included care plans for two people, medication administration records, staff training records, policies, quality audits and safety inspections.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

The service was safe. Comprehensive risk assessments had taken place before people had gone to live at the home. These included physical health, mobility, nutrition and communication. The home was suitable for the people living there and recommendations made following safety inspections had been, or were in the process of being implemented. Medicines were administered safely.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. The manager understood when an application should be made, and how to submit one. Training about deprivation of liberty safeguards for all staff had been arranged.

Is the service effective?

The service was effective. People told us 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 they knew them well. One person said, 'If I need help, I get it.' Another person said, 'They take good care of me here.' Staff had received enough training that was relevant to the needs of the people living at the home.

Is the service caring?

The service was caring. A person using the service said the staff were caring and, 'They listen to me,' and the staff were all very kind and patient.

We spoke with staff who knew people's needs and we observed them interact with different people in a kind and caring way. We saw that staff were patient and gentle when helping people. The home had a family atmosphere and more than one person told us that living there felt like being in a family home.

Is the service responsive?

The service was responsive to the changing needs of people using the service and to comments and suggestions. Assessments of people's needs had resulted in care plans that staff read. The care plans helped staff to know the needs and care that individual people required. Care plans were changed if people's needs changed, for example after a person had fallen. People told us staff were responsive to their needs and requests. A person said, 'If I don't like something, they change it.'

There was an updated complaints policy in place although no complaints had been recorded since 2009.

Is the service well led?

The service was well led by a registered manager. They were supported by a senior carer. People said the home was well run and the manager was visible and supportive. People said the manager talked with them every day. The service had a system in place to monitor and assess the quality of the service.

The people who used the service said they were very happy with the care they received and described the staff as 'friendly' and 'nice'. One person told us "I am happy here.' Another person said, 'I love this place because it's small.'

The people who used the service commented on how much they enjoyed the food. One person said, 'The food is very good.'

On the day of the visit the people we spoke with said no activities were provided.

A relative of one of the people who used the service described the staff as 'very good'. They said the staff always responded quickly if their relative was unwell and contacted a doctor immediately. One relative told us, "I am very happy with the care my relative receives. The staff are respectful and the home is not regimented at all. Because the home is small, it has a family atmosphere".

Staff were trained on how to safeguard people from abuse and harm and this was part of the on-going training programme. None of the people who used the service or their relatives had any concerns to raise about the staff who supported them.

The manager had completed a range of health and safety checks to ensure a safe environment was maintained and the equipment used was in good order.

Relatives were aware of the complaint procedure which meant they knew what to do if they were unhappy with the standard of care they received.

We carried out this inspection to check that the provider had taken action since our last inspection on 19 February 2013.

During our last inspection we found minor concerns that capacity assessments were not always completed when people did not have the capacity to provide informed consent. We also found minor concerns that the provider did not did not have clear policies and procedures in place for infection prevention and control. We found they did not operate effective audit systems to ensure those policies were implemented in practice.

During our inspection on 25 June 2013 we found that the provider completed capacity assessments when people were identified as being unable to provide informed consent. Assessments involved relevant people such as healthcare professionals and relatives in order to make decisions that were in people's best interests. This was in line with regulatory requirements.

We found the provider had implemented an infection prevention and control programme along with risk assessments which showed they had policies and procedures in place for infection prevention and control. The provider had also implemented a cleaning schedule. The manager used the schedule to audit standards of cleanliness on a weekly basis. This showed the provider had an audit system in place to ensure key practices were being implemented.

Care and support was person centred and people's views were taken into account in the way the service was provided and delivered. We saw that in most cases requirements were agreed with people and consent was obtained before any care or support was provided. However, we found that adequate systems were not always in place to support people when they lacked the capacity to make an informed decision to ensure care and support was provided in the person's best interests. This was not in line with best practice.

There was a choice of suitable and nutritious food available and people were supported where required to enable them to eat and drink sufficient amounts to meet their needs.

We saw staff were suitably trained and qualified to support the health and welfare needs of people who used the service. There were systems in place to deal with comments and complaints effectively.

We looked around the home and found general cleanliness levels to be of a good standard but the provider did not did not have clear policies and procedures in place for infection prevention and control and did not operate effective audit systems to ensure those policies were implemented in practice.