4 June 2014
During a routine inspection
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
This is a summary of what we found-
Is the service safe?
We found the service was safe because people were cared for by staff who were knowledgeable about their needs and had the skills to provide the support people required. People were assessed prior to receiving care and support plans were developed to show how their needs would be met. Risk assessments were completed and measures to reduce risks were put in place.
Medicines were handled appropriately and by staff who were trained in medicines management. Each person had a Medication Administration Record in place, which was completed appropriately after staff had given people their medicine.
People who use services were only deprived of their liberty when this had been authorised by the Court of Protection, or by a Supervisory Body under the Deprivation of Liberty Safeguards. At the time of the inspection, one person was protected appropriately by the safeguards.
Is the service effective?
Systems were in place to ensure staff received regular one to one supervision sessions. Staff also received annual appraisal. One staff member told us the manager was, 'open' and if they had any problems they did not need to wait until supervision. This ensured staff were supported in their work.
Staff told us training was very good. One said they had been, 'getting all sorts of training'. The manager told us they accessed a range of training providers to ensure they could get training for staff when they needed it. Records showed staff were up to date with training such as moving and handling, diabetes, epilepsy and infection control. This ensured people were supported by staff who knew how to meet their needs effectively.
Is the service caring?
People's diversity, values and human rights were respected. We found staff were mindful of people's privacy and dignity when they supported them with personal care. We spoke with three staff who described the process they followed which included ensuring doors were shut and keeping people covered up where possible during personal care.
People who used the service told us they felt respected by staff and were supported to make decisions, such as what clothes to wear. Staff gave us examples regarding how they offered choice to people when supporting them with personal care.
People felt staff cared about them. One person told us, 'The care is very good here, I'm taken care of here.' Another said the staff were 'great, always helpful'.
We observed staff as they spoke with people or supported them to move around the home. We saw they were kind, calm, respectful and considerate. Staff offered one person a cardigan as they thought they might be cold and the person accepted this. Staff saw that another person needed a tissue and they gave them one. These examples showed staff looked at people and noticed when they needed something but were not able to ask for it.
Is the service responsive?
We found staff liaised with health care professionals when needed. Staff noticed when people were unwell and ensured they contacted the doctor. We sat in the office whilst the person in charge of the shift gave a 'handover' to staff whose shift started in the afternoon. The staff member talked about how each person had been and whether any medical issues had been noted, such as a person feeling unwell. This meant staff were aware of people's changing needs and could respond appropriately.
Is the service well-led?
The provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider sought people's views and a system of regular audit was in place to ensure the service was well led.
Audits included care plans, nutritional needs, infection control, accidents and incidents, complaints, staff training and supervision. Audits identified whether any action was needed to improve the service as well as who was to undertake this. A higher level of auditing was then undertaken by a senior manager in the organisation and was used to inform the provider. We saw these audits had been completed. This meant the manager and provider had an overall view of the service and how people's needs were being met.