We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;Is the service safe?
Care records contained detailed risk assessments which had been carried out for each element of care planned. Actions to reduce any risk identified were documented. Risk assessments balanced risk with the rights of people to maintain their independence. People told us that staff took care of them and made sure they were safe.
Staff were clear about their role and responsibilities in relation to consent. Before people received any care or treatment they were asked for their consent. Consent forms were completed and signed by people who received a service and documented in the care record.
Care plans were clear about people's ability to consent for themselves. We saw that, where appropriate, mental capacity assessments had been carried out.
The provider had appropriate systems in place with regard to safeguarding adults. The provider responded appropriately to any allegation of abuse and investigations were robust. Staff received safeguarding training at induction and had annual updates.
Is the service effective?
Care records were well written and reflected the needs and wishes of the people who received a service. People told us they were fully involved in developing their care plan. Daily records demonstrated that care staff delivered care in line with the care plan. Care plans contained sufficient information for staff to carry out the care required.
The minutes from staff meetings demonstrated that staff received updates, information and guidance aimed at improving care. There was evidence that incidents, complaints and feedback were discussed. Any appropriate lessons were learned and necessary actions were monitored through supervision.
Is the service caring?
We talked with nine people and the relatives of five others who used the service. All the people we spoke with said the service was good or very good. People we spoke with described the service as: "Kind and Caring", "Absolutely fabulous", "Professional, with a sense of humour".
Feedback from the annual survey and care reviews were generally very positive.
Is the service responsive?
All the people we spoke with said that they had been asked for their views about the service they received. Issues raised in surveys and reviews were discussed at staff meetings and supervision. People told us they were confident that any issue raised or complaint made would be thoroughly investigated and acted upon.
Policies and procedures were up to date and reflected national legislation and guidance.
Is the service well-led?
Staff told us they felt well supported by their supervisors and the registered manager. They told us that they were treated fairly and that issues they raised were dealt with appropriately.
Staff had good access to a wide range of training relevant to their role. All staff received a comprehensive induction programme prior to working alone.
There were systems and processes in place to monitor the quality of the service. These included analysis of incidents and complaints, satisfaction surveys and supervision visits to observe care staff delivering care.