Background to this inspection
Updated
3 June 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered 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.
The inspection took place on the 21 March 2017 and was unannounced.
The inspection was completed by one adult social care inspector and an expert by experience who had experience of caring for older people. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to the inspection we contacted the local authority safeguarding team, and quality monitoring team who did not raise any concerns about the service. We also reviewed notifications on our system relating to the service.
During the inspection we spoke with five people who used the service and four family members. We spoke with three members of staff, the registered manager and the area manager. We also spoke with two visiting health professionals. We looked at the care records for four people, and the recruitment records for three members of staff. We made observations on the interior and exterior of the premises. We also looked at other records relating to the day-to-day running of the service, for example audits and meeting minutes.
Updated
3 June 2017
The inspection was unannounced and took place on the 21 March 2017. This was the first time the service has been inspected since a new registered provider had taken over the service in November 2016.
The service is registered to provide accommodation for older people, and people living with a physical disability who require personal care. It is registered to accommodate up to 43 people. At the time of the inspection visit there were 32 people using the service.
There was a registered manager in post who had been registered with the CQC since November 2016. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
During the inspection we found that the majority of staff had not recently completed training in supporting people living with dementia. Consideration also needed to be given to how the environment could be adapted to meet the needs of people living with dementia. We have made a recommendation around this to the registered provider.
People commented that they did not think there were enough activities available. One person told us they felt “lonely” at times, and other people told us they wanted to go on more day trips. Activities were taking place on a daily basis, however these were regularly attended by the same, small group of people. Following the inspection the registered manager was able to evidence that people were being consulted on what improvements could be made. We have made a recommendation to the registered provider around activities.
People commented that they found the quality of the food to be variable. This had also been reflected during a resident’s meeting carried out in February 2017. We asked that the registered manager and the registered provider to take action with regards to this. Following the inspection the registered manager was able to evidence that people were being consulted on what improvements could be made.
During the inspection visit we observed that people received a diet that was appropriate for their needs, for example diabetic options. Staff were attentive and patient whilst supporting people. This helped protect people from the risk of malnutrition.
People received their medication as prescribed. We identified some minor issues which we raised with the registered manager so she could address these.
Audit systems were in place to identify issues within the service and make improvements. During the inspection we identified some concerns raised by people, and the registered manager took action to address these concerns. This showed that the registered manager was proactive in ensuring that the quality of the service was being maintained.
We identified that sluice room doors were not locked when we arrived at the service; however these remained secure for the remainder of the day after we raised this with the registered manager. Staff had received training in infection control and we saw examples where they appropriately used personal protective equipment such as disposable gloves and aprons as required. This helped to minimise the risk of infection.
Not all staff had completed training in the MCA. Whilst a majority of people told us that staff offered them choice, and were observed some positive examples around this, two people commented that they sometimes had to remind staff that they were able to make their own decisions. The registered provider confirmed that staff were booked to complete training in the MCA.
People told us that staff were kind, caring and respectful towards them. We observed examples where staff responded to relieve people’s distress where they became anxious. It was apparent that positive relationships had developed between the two groups.
Staff had received training in safeguarding vulnerable people and were aware of how to report their concerns to the relevant authority where required. The registered manager was aware of the local authority’s safeguarding procedure and adhered to this. This helped protect people from the risk of abuse.
Recruitment processes were safe and the appropriate checks had been carried out to ensure that new staff were of suitable character to work with vulnerable people.
Each person had a care record which outlined their care needs and what staff needed to do to support them. These were personalised and included details around their personal preferences. This ensured that staff had up-to-date and accurate information relating to the support that people required.
The registered provider had a complaints process in place which people were familiar with. People and their family members told us that they would feel comfortable making a complaint, but also commented that they did not have anything to complain about. The registered manager had responded promptly to the one complaint that had been received within the past 12 months.