2 July 2014
During a routine inspection
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
This was the service’s annual scheduled inspection, which was brought forward because of some concerns that had been raised with us. One of the inspectors arrived at the home at 7am, to see the arrangements that were in place for night time staffing and support in the early morning. During our visit the inspection team spoke with ten people who used the service, three relatives, nine staff and the home’s owners. We also spoke with two visiting health care professionals. The inspection team focused on the outcome areas and regulations for consent, care & welfare, meeting nutritional needs, cleanliness and infection control, management of medicines, staffing and assessing and monitoring quality.
Is the service safe?
People were cared for in an environment that was clean and hygienic. One person told the expert by experience “They clean my room and bathroom every day.” Two visiting health care professionals told us that, in their experience, the home was clean and fresh when they visited, with personal protective equipment and hand wash readily available.
Safe systems were in place to administer, store and manage people's medications.
There were enough staff on duty to meet the needs of the people living at the home. The expert by experience observed that staff were available at all times and most people felt that staff were responsive and available when needed.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that one person who used the service was subject to DoLS at the time of our visit. However, the deputy manager was aware of the outcome of a recent case law judgement made by the Supreme Court and the impact this had for people living at the service. They confirmed that they were in discussions with the local authority about this and were in the process of providing information to them regarding the people at the home who lacked capacity and may now be considered to be deprived of their liberty.
Is the service effective?
People told us that they were happy with the care they received and felt their needs had been met. Comments made by people who used the service included “They look after me well, I can have a shower anytime” and “I enjoy having my hair and nails done, it makes me feel good”. Comments made by relatives included “The staff are really good to mother” and “The last four or five months it has improved. My (relative) is happy here.” Staff were able to demonstrate that they understood people’s care and support needs and that they knew them well. For example, by explaining how they cared for different people in different ways.
Is the service caring?
Comments made by people who used the service included “The staff, I love them all, I get everything I need, I wouldn’t change anything” and “They sit and talk whenever they have time, they are very nice, kind and helpful.” We saw staff interacting pleasantly with people. For example, holding people’s hands while chatting and offering reassurance while assisting people.
The care records we looked at contained a comprehensive assessment and care planning documentation system. The records we looked at contained assessments, risk assessments and care plans, identifying the help and support people needed. The records included information about people’s individual wishes, preferences and abilities, to help staff provide care in an individualised way.
Is the service responsive?
All the people they spoke with said they could choose how they were cared for. For example, some people took themselves to the toilet and showered independently, while others were given help if needed. People told the expert by experience that they could choose how they spent their day. For example, spending time in their room, in the lounge or in the garden, or out with family.
The records we looked at contained assessments, risk assessments and care plans, identifying where people were at risk and the help and support people needed. This included systems to assess and monitor people’s risks from pressure damage or malnutrition. We saw that risks were monitored regularly and that actions had been taken when risks had been identified. For example, discussions with the doctor or nurse, or a referral to the dietician.
We saw that staff were responsive and tried to cater for people’s individual wishes. Staff asked if people were finished their meal and if they wanted anything else before clearing away their plates and cups. For example, “Do you want anything else (name of person)? Another cup of tea?” This showed that staff responded appropriately to people’s different preferences and needs.
Is the service well-led?
The service had a registered manager, but the person registered with us was no longer carrying out the registered manager’s role. An acting manager was in place, but had not yet applied to register with us. The provider needs to take the appropriate steps to ensure that the previous registered manager is removed from the register and the new manager applies to register with us.
People told the expert by experience that they were well looked after and had no complaints about their care. People said if they had any concerns they would tell the manager. One relative commented that they felt able to raise issues and felt they would be listened to. Quality monitoring systems were in place, to gather feedback from people who used the service and check that appropriate standards were being maintained.