10 July 2014
During a routine inspection
Below is a summary of what we found. The summary describes what people using the service, and the staff told us, what we observed and the records we looked at.
Is the service safe?
People were treated with respect and dignity by the staff. Care plans had been developed. They identified people's needs and were reviewed regularly. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. Risk assessments were in place for things such as moving and handling, safety in bed and showering. Control measures had been put in place. This meant that people's needs were met and people were kept safe. Relatives we spoke with confirmed they felt the service was safe.
Staff had received training in the Mental Capacity Act 2005. Records identified when people lacked capacity to make their own decisions. We saw that best interest decisions had been made. The registered manager told us they would develop the recording of their own capacity assessments and record how best interest decisions had been made. This meant that systems were in place to safeguard people as required.
The service did not currently have responsibility for the management of medicine. This was confirmed by relatives we spoke with.
People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We saw staff training records and saw that staff received regular supervisions. Staff were also observed to ensure they provided a quality service. This meant that people received care and support from staff who had the skills, experience and knowledge to meet their needs.
Recruitment practice was safe and thorough. Disciplinary procedures were in place along with systems for staffs return to work following absence. This was to ensure people's safety was maintained. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One relative said, 'The service is very good, X is very happy.' Another relative said, 'It is an excellent service, they are very nice people.'
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. People had access to a copy of the complaints procedure. This reduced the risks to people and helped the service to continually improve.
Is the service effective?
People experienced care and support that met their needs. Relatives told us how people were supported. This was in line with their care plans. The registered manager told us they worked with other agencies to ensure people's health and social care needs were met. Relatives confirmed that the people receiving care and support were involved in decisions about their care. This meant that people received care in the way they wanted.
Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.
Is the service caring?
People were supported by kind and attentive staff. Staff we spoke with told us how they supported people. Relatives told us that staff were caring. One relative said, 'They [staff] are first class, they are very caring.' Relatives were very positive about the staff and the care they received.
People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain relationships that were important to them. One person was being supported to increase their mobility so they could attend church. This meant people's diversity and individuality were promoted and respected.
Is the service responsive?
We saw records that showed the service responded quickly to meet people's needs and ensured people's safety and dignity was maintained. For example, as a result of a fall the service had requested an occupational assessment and had requested the doctor review the person's medicine. Relatives confirmed that people were given choices and encouraged to express their views.
People we spoke with were aware of how to make a complaint. Relatives told us they had no reason to make a complaint.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. All staff felt supported in their roles and felt their views were listened to. Staff we spoke with told us they were happy working for the service.
The service had a quality assurance system in place. A number of audits were undertaken monthly and annually. The registered manager told us that action would be taken as a result of findings. This meant the quality of the service was able to continually improve.