Background to this inspection
Updated
4 May 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 29 January and 1 February 2016 and was unannounced. The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the home, what the home does well and improvements they plan to make. We also looked at previous inspection reports and notifications about important events that had taken place at the service, which the provider is required to tell us by law.
We spoke with eight people about their experience of the service and one relative of someone using the service, who was visiting. We spoke with two care staff, the cook and the registered manager to gain their views.
We spent time looking at records, policies and procedures, complaint and incident and accident monitoring systems. We looked at three people’s care files, three staff record files, the staff training programme, the staff rota and medicine records.
A previous inspection took place on 24 November 2014; the service had met the standards of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.
Updated
4 May 2016
The inspection was carried out on 29 January and 1 February 2016 and was unannounced.
The service provides accommodation and support for up to sixteen older people. Accommodation is arranged over two floors. There were fourteen people living in the service when we inspected some of who were living with dementia others were independent.
A registered manager was in post and was present throughout the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. At the time of the inspection, the registered manager had not applied for DoLS authorisations for some people living at the service, who were unable to leave without the support and supervision of staff. The registered manager understood their responsibilities under the Mental Capacity Act 2005. However, people were being deprived of their liberty.
Recruitment checks had taken place prior to staff starting work at the service, however gaps in people’s employment history had not been explored. Staff felt supported in their role and received regular supervision. Staff told us the registered manager was approachable and there was an open culture within the service. We have made a recommendation about this.
A system was not in place to determine if there was enough trained staff on duty to meet people’s needs. Staff told us they had received the training and support required to fulfil their role. However, staff had not received the specialist training they required to meet people’s needs. We have made a recommendation about this.
People received their medicines safely and when they needed them. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely. Guidance was not available to staff regarding medicines prescribed as ‘as and when’ PRN.
People were treated with kindness and respect. People’s needs had been assessed to identify the care they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. Detailed guidance was provided to staff about how to provide all areas of the care and support people needed.
People told us they felt safe. Staff had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s safety had been assessed and measures put in place to manage any hazards identified. The premises were maintained and checked to help ensure people’s safety.
Staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained. People told us that they had no complaints and if they did they would speak to the registered manager or staff.
People had access to the food that they enjoyed and were able to access drinks with the support of staff if required. People’s nutrition and hydration needs had been assessed and recorded. People were asked for feedback on their food and action was taken if required.
People were supported to maintain good health. Staff had up to date information to support people to remain as healthy as possible. People were supported to stay in touch with people that mattered to them.
Processes were in place to monitor the quality of the service being provided to people. Records were up to date and stored appropriately. A complaints policy and procedure was in place and people knew how to report any concerns they had.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.