We spoke with two of the five people who used the service on the day of our inspection. We gathered evidence of people's experiences of the service by observing how they spent their time and we noted how they interacted with other people who lived in the service and with staff. We also spoke with two staff members, the manager and provider. We looked at five people's care records. Other records viewed included staff training records, staff rotas, health and safety checks, medication records and satisfaction questionnaires completed by the people who used the service, their relatives and staff. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is a summary of what we found;
Is the service safe?
When we arrived at the service we were asked for our identification and asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.
People told us they felt safe living in the service and that they would speak with the staff if they had concerns.
We saw appropriate processes were in place with regard to medication and it's administration, so that people could be confident they were protected from the unsafe use and management of medicines.
The service was safe. We saw records which showed that the health and safety in the service was regularly checked.
We saw that people's personal records including medical records were accurate and that staff records and other records relevant to the management of the service were accurate and fit for purpose.
Is the service effective?
People told us that they felt that they were provided with a service that met their needs. One person said: "The staff are very nice and friendly."
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information.
People were supported to be able to eat and drink sufficient amounts to meet their needs. People we spoke with told us they were provided with a good choice of meals on a daily basis. One person told us: 'The food is lovely, all home cooked." Another told us: 'The food is good, I am just not very hungry today."
We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.
Is the service caring?
We saw that the staff interacted with people who lived in the service in a caring, and respectful manner. We saw that staff treated people with respect.
Staff had a good knowledge and understanding of people's care and support needs, including recognising and supporting them as an individual. Where people required assistance, staff provided this in a timely manner and at a relaxed pace. This ensured people received care and support consistently and in ways that they preferred.
People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.
People's choices were taken in to account and listened to. People who used the service were generally provided with the opportunity to participate in activities which interested them. The daily care records viewed provided little information confirming activities undertaken.
People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them. People can therefore be assured that complaints are investigated and action is taken as necessary.
People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and district nurse.
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.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good service at all times.
The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed promptly. The service had processes in place to collate the information they had gathered, identify the service's strengths and weaknesses, and plan the actions required to improve the experiences of people who used the service. This ensured continued improvement in the areas identified.