17 January 2017
During a routine inspection
This unannounced comprehensive inspection was undertaken by one inspector which took place on 17 January 2017.
A registered manager was in post at the time of the inspection and had been registered since the service was registered in January 2016. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the agency. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff had a good understanding of their knowledge on how to keep people safe and also of the organisations they could report any incident of harm to. However, not all accidents and incidents were reported to the appropriate authorities. This put people at risk of not being as safely supported as they could have been. A sufficient number of suitably skilled staff were in post to meet people’s assessed needs in a safe way.
Only staff deemed suitable after being subjected to a robust recruitment process were offered employment. People’s medicines were administered as prescribed. However, the competency for staff to do this safely had not been assessed. This meant that there was a risk of people not being administered their prescribed medications safely.
People’s health and nutritional needs were met and supported by staff who possessed the necessary care skills. This was in identifying when health care interventions were required. People, with staff’s support, could access health care services according to their needs.
The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA] and to report on what we find. The provider was aware of what they were required to do should any person lack mental capacity. Appropriate authorisations were in place to support people in a legal way. This showed us that the registered manager and care staff were aware of, and liaised with, those lawful bodies that were responsible authorising guardianships to lawfully deprive people of their liberty. Staff had a good understanding about the application of the MCA code of practice.
Staff undertook training appropriate to their role and they were mentored through a shadowing system with experienced staff. This gave staff the necessary skills they needed to undertake their role effectively.
People’s care was provided by staff with kindness who valued people’s privacy, dignity and who were treated in a respectful way. People, their relatives or representatives, were enabled through various means and support to be involved in assessing, planning and the review of their care and care planning.
A positive difference was made to people’s lives by being provided with various opportunities to prevent isolation in the community or at home. Assistance was provided by staff so that people could be as independent as possible such as help with work, education, hobbies and pastimes. This helped people with maintaining an active lifestyle based upon people’s preferences and needs.
An effective system was in place to gather and act upon people’s suggestions, concerns and complaints. Concerns, comments and suggestions were acted upon before they became a complaint. Where people had raised a concern this had followed the provider’s process, to the satisfaction of the person.
The registered manager was supported by an area manager and worked with a team of care staff who recognised the quality of their leadership. Staff who had been trained according to their role had the support mechanisms in place that they needed to fulfil their role effectively.
People, their relatives and staff were involved and enabled to make suggestions to improve how the service was run. Quality monitoring and assurance process were in place and actions were taken whenever improvements were identified.