We considered our inspection findings to answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People were treated with dignity and respect by the staff.
People were cared for in an environment that was safe, clean and hygienic.
Care plans were individualised and contained information that directed and informed staff to provide appropriate care and support. We saw risk assessments had been undertaken and were regularly reviewed.
People were safe because the service had an effective system to manage accidents and incidents and learn from them so they are less likely to happen again.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLs) which applies in care homes. The service understood the requirements of the Mental Capacity Act 2005 and the related Deprivation of Liberty Safeguards, and put them into practice to protect people. We were told and we saw, an appropriate application had been made for an authorisation of a DOLs care plan. Newly appointed staff received an induction prior to starting work which included a period of shadowing more experienced staff.
Mandatory training was mostly up to date and staff received further training specific to the needs of the people they supported. Some staff required updates.
Policies and procedures are in place to make sure that unsafe practice is identified and people are protected.
Is the service effective?
We observed staff caring for people. It was clear from our observations and from speaking with staff, and relatives of people who used the service, that staff had a good understanding of people's needs.
We spoke with three people who used the service, their comments included 'I am very happy here, the staff are lovely' and 'Yes its fine here, no problems, I do as I wish'. Two family members who were visiting a person staying at Caprera for respite told us 'it is wonderful here; we wish X could live here all the time' and 'the staff are fantastic'.
We saw there was appropriate care planning documentation used in respect of people who lived at the home. We looked at a range of care documentation which evidenced that people's needs were well understood and staff acted with respect and care in supporting people appropriately. Care plans mostly reflected people's current individual needs, choices and preferences.
People, or their representatives were not always involved in their assessment and review of care needs.
People told us, and we saw, their views and experiences had been sought. We saw the results of such surveys had been acted upon.
Some people required to be moved using equipment. We saw this equipment was readily available to people. We saw each person who required a hoist to move them, had their own sling in their room. This ensured people's dignity was protected as slings were not shared.
We saw some people had their end of life wishes clearly stated in their records.
The premises had been sensitively adapted to meet the needs of people with physical impairments.
Visitors confirmed that they were able to see people in private and that visiting times were flexible.
Staff had effective support, induction, supervision and appraisal.
Is the service caring?
We spoke with three people who lived at Caprera. People told us they were happy with the care provided. One person told us 'I am well looked after here'.
People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people.
People told us they were able to do things at their own pace and were not rushed. People's preferences, interests, aspirations and different needs had been recorded. Care and support was provided in accordance with people's wishes.
We saw people were given a choice as to where and when they had their meals. We saw some people chose to eat their meals in their rooms; whilst others ate in the communal dining area. People we spoke with told us the food was always good and enjoyable.
Appropriate professionals such as district nurses, GP's and tissue viability nurses were involved in the planning and management of care and decision making.
Is the service well led?
Caprera had a registered manager. This person was returning from maternity leave on a part time basis, however, there was organised management cover in place for when the registered manager was not going to be at the home.
Caprera had regular support from the district nursing team and GP's from local practices. This ensured people received appropriate care in a timely way.
Accidents and incidents were recorded and monitored.
Staff meetings were held regularly, and staff felt supported and listened to by management. Staff told us they felt there were enough staff on duty at the home .
Audits were carried out monthly on areas such as accidents, training, medication and care documentation. We saw some care records contained gaps and these gaps had not been identified on the audits we saw.
We saw CQC registration requirements, including the submission of notifications and any other legal obligations were met.
Is the service responsive?
Caprera had an activity co-ordinator who planned and organised activities for people who lived at the service.
People told us they were offered choices at Caprera. We were told people could make choices regarding the times they got up and returned to bed, what they did during the day and what they ate.
People who required assistance with decision making were offered appropriate support.
People's needs had been assessed before they moved into the home.
People using the service, their relatives and friends completed a quality assurance survey. Where shortfalls or concerns were raised these were addressed.
People's care needs were regularly reviewed; however, this was not always done with the involvement of the person or their representative.
Caprera had a complaints procedure in place. People who lived at the home felt able to raise any concerns.