9 March 2011
During a routine inspection
We found that people who use the service were able to get up and go to bed when they chose and they were generally able to make their own decisions about how they spent their day and evenings. We also saw evidence that care plans included details on personal preferences and choices of people living in the home to ensure their individual needs and choices are respected.
We observed that generally people us who use the service were provided with support when they needed it to ensure they received a good standard of personal care and support. People who use the service appeared to be well looked after and were wearing clean clothing. There was clear and respectful communication between staff and people who use the service and staff treated them in a kind manner. People said they had regular contact with their GP and other health care professionals. One person said the doctor came every week, and they could request to see them if necessary. Another person said district also nurses visited regularly. People who use the service told us 'The staff help me with everything I need help with" and "I press the buzzer when I need help and the staff come as soon as possible". A variety of activities are provided to ensure the social needs of people who use the service can be met and, we saw evidence of trips out, flower arrangements and other events. On the day of our visit we observed a group of people making preparations for an annual Easter Bonnet competition and in the afternoon a large group enjoyed taking part singing and dancing to a musical entertainer. People using the service said 'I tend to stay in my room in the morning and then go down to join activities just before or after lunch' whilst others told us' I prefer to relax in my room but there are various activities available'. Recent relative feedback however stated 'At the moment there is no chance of xxx going to activities 'we feel xxx is missing out and that with no stimulation xxx will deteriorate further'. Staff told us "It would be good if we could get people out more often, we do take people for a walk but they enjoy trips outside the home".
People using the service told us: "The food is very good", "Meals are alright", although one told us "The food is sometimes OK but sometimes not. I'm fussy there's a lot of things I don't like. They make a lot of stews and casseroles, which I don't like". "There's always two choices and if I don't like either they'll get me something else".
People that use the service confirmed they had regular contact with their GP and other health care professionals and their case files contained evidence their needs were being appropriately monitored.
The provider sent us a relative complaint alleging issues of neglect / lack of dignity and rough treatment that was subject to an ongoing investigation by the Local Authority and we saw good evidence of cooperation with them to address this issue appropriately. The latest training statistics indicated 82% of the staff had completed training to ensure they know how to safeguard people using the service from harm.
On the day of our visit the environment was homely and clean. All areas were fresh smelling and pleasant and we saw domestic staff working to keep the home clean. We spoke to three staff who told us they had received training in infection control and we looked at the staff training matrix and saw that staff had completed this.
Whilst we did not receive any direct comments from people who used the service about the management of their medication, we did observe that management checks were being carried out to ensure they were kept safe from harm in regards to their medication needs.
We observed the building was clean, tidy and free of odours. Bedrooms were relatively spacious and people were allowed to personalise them. Generally the home had a warm welcoming atmosphere and staff interaction with people who lived there was observed as friendly and positive.
We observed staffing levels to be sufficient for meeting the needs of people living in the home and people told us "The staff are always asking me if I'm alright".
We were told by people using the service that "The staff are lovely". and "Everyone is kind". Staff confirmed they were provided with training to do their jobs and there was evidence of other courses that were planned.
There was evidence of consultation with people that use the service and their relatives and a suggestions box was on display in reception. We were told that an action plan had been formulated from the comments and suggestions received from a recent survey. We found the service had clear quality monitoring systems in place. They used a range of internal and external information sources, for example, safeguarding recommendations, feedback from contract and commissioning and staff meetings. There was also evidence of internal auditing of the service and we found that issues had been acted upon when needed.
A relative told us "I have raised concerns and they have been acted upon, I just speak to the staff and someone sorts it out". Recent relative comments in the quality assurance records stated 'I am so relieved by how my husband is and how welcome we are made', 'Staff are very kind with my mum' however, one stated 'Call backs never seem to get through'.