Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who use the service, the staff supporting them and from looking at records. We spoke with seven of the twelve people using the service, two members of staff, the cook, provider, manager and three visiting relatives. We looked at four people's care records. If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People we spoke with told us they felt safe and a relative said they had, 'Specifically chosen this service on the recommendations of others'. Another relative said, 'Our previous experiences were poor, we chose this home because it has a reputation of being safe, caring and good staff and manager, I've not been disappointed'.
We saw that systems were in place to make sure that staff learned from events such as complaints, accidents and incidents. This had helped the service to improve the safety of people for example by increasing staff at peak times in the day when people were more likely to fall.
We saw staff practiced in a way that protected a person's safety who through illness had temporarily lacked capacity with regard to their own safety. The service had policies and procedures in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do. No DoLS applications had needed to be submitted. This means that people will be safeguarded as required.
We found that people were protected against risks of infection because staff followed infection prevention and control procedures. We saw the facilities were clean, fresh and ventilated. Cleaning schedules were in place to promote infection control standards and staff wore personal protective equipment (PPE).
We found that the safety and welfare of people using this service was protected because the provider had followed safe recruitment practices. There was a record of work history, previous conduct and references and checks by the Disclosure and Barring Service, (DBS). These checks ensure that staff are suitable to work with vulnerable adults.
Is the service effective?
Visiting relatives told us that the service was effective in meeting people's needs. For example through ensuring their health care needs were addressed in a timely manner and through ensuring staff had the right knowledge and skills to understand people's needs. One staff member told us, 'The owners teach by example, they are very knowledgeable, supportive to us and give us the direction we need".
People who used the service, relatives and staff told us that people's care was regularly discussed and planned with them. This meant that staff had the information they needed to promote people's wellbeing.
We found staff had appropriate support once they were recruited to effectively meet people's needs. We saw that staff received an induction and on going supervision to ensure they could reflect on their practice and develop the skills necessary to effectively meet people's needs.
Is the service caring?
We saw staff interact with people in a caring and responsive way. One person told us, 'Staff are lovely; they take me out, look after me nothing is too much trouble'. A relative said, 'The manager and staff are interested, caring and responsive, anything they can do they do and mom is so much better here'.
Is the service responsive?
We found that the provider had regularly asked and acted upon the comments and views of people using the service and their relative's. We saw this had led to improvements in staffing levels and activities for people both inside the home and in the community. We saw the daily routines necessary in running a home provided choices to people in response to their needs. For example where people ate, and when, times of personal routines and providing more staff contact time with people in response to their emotional needs.
Is the service well-led?
The service was led by a registered manager and business partner both qualified nurses with a wealth of health care experience. We saw that they had put in place systems to ensure good standards of care. They ensured staff were regularly supervised and that competency checks were carried out to ensure staff performed at the required standard.
Staff told us they had, "Good leadership, guidance and direction". We saw care plans had been improved to provide staff with better guidance in meeting people's needs.
We saw that a number of audits were carried out in order to assess the quality of care provided. The provider had sourced external legal consultants to ensure the systems they used met their needs.