Peoples views and experiences were taken into account in the way the service was provided and delivered in relation to their care.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?
We visited the service as part of a scheduled inspection.People told us that they felt safe. When we spoke with the manager and staff they understood their role in relation to safeguarding the people they supported. The registered manager had notified us about two medication errors. When we visited we saw that the medication systems had been audited by the community pharmacist and were meeting the regulations. We spoke with the pharmacist who said that they had no concerns about the administration of medication in this service. We observed one staff member administering medication in a safe and appropriate manner. This meant that people received the correct medication at the correct time.
On the day we visited we found enough staff on duty to meet the needs of the people who used the service. The registered manager arrived later in the morning. We spoke to people who lived at the service. One person told us," I like my flat here and can come and go as I want but I can get support when I need it".
Each person who used the service had their own bedroom or flat and individuals were assisted by staff to clean their rooms. The manager told us that, "People clean their own rooms with our support on a daily basis". Individuals had decided upon the levels of cleanliness in their rooms but some of the rooms were an infection control risk. This meant that the provider was not protecting people against the risk of infection because they were not effectively maintaining standards of cleanliness and hygiene at this service.
There was a fire risk assessment in place at the service but there were no individual fire risk assessments and personal emergency evacuation plans in place.A number of people at the service smoked in their rooms so we asked for advice from North Yorkshire Fire Safety Officer.They plan to carry out their own audit to make sure that people's safety was maintained.
Recruitment procedures were safe and effective. No member of staff was allowed to work until a Disclosure and Barring (DBS) check (previously criminal records check) is carried out to ensure that people are cared for by suitable people. Staff have all received training in areas relevant to the people who used the service. There was no system in place in order for the manager and staff to learn lessons and identify trends from events such as accidents and incidents, complaints and safeguarding incidents. This meant that staff were not always adapting and updating practice following learning from incidents. This may have resulted in people who used the service not having effective and relevent support. It was not possible to confirm that the service was safe and we have asked the provider to make improvements.
Is the service effective?
Care plans were written after consulting people who used the service and health and social care professionals. We observed that specialist professional staff were involved with people who used the service. For instance one person who used the service attended a community mental health service. This was in order to have their blood levels checked due to the type of medication they were taking for their mental health condition.
We spoke with a district nurse who came into the service on the day of our inspection. They said ," District nurses visit daily and I find everything to be okay. I have no problems with this service".
We spoke with people who used the service and they told us they were happy with the support they received from staff.
Is the service caring?
The staff knew people very well and gave support to people in a friendly and caring manner throughout our inspection. The manager supported the staff and people who used the service in friendly and helpful way. One staff member told us that if they needed to they could go to the manager with any concerns.
When we walked around the service we saw people greeting the manager and stopping for a chat. One person who used the service said," They look after me".Another person said," " I'm really happy here, I love living here and the foods good". The atmosphere was relaxed.
Is the service responsive?
Records confirmed that peoples history and present support needs were recorded and that appropriate support was provided in accordance with their wishes. People had been to visit or been seen by healthcare professionals in order to maintain their well being.
The manager showed us a new care file system that was being implemented. This was well laid out and organised with sections for all areas of care and support. This made the care planning system more effective for people who used the service although it was not in operation at the time of our visit.
The complaints procedure was clearly displayed in the entrances of the service in order that people could see clearly how to make a complaint if they wished. One staff member told us," I would report any incidents to the manager or the owners".
Is the service well led?
The registered manager had worked at the service for eighteen months and was beginning to make changes to the documenting systems, training of staff and the environment. It was clear on the day of the inspection that there were still improvements to be made but the manager was effective in leading the way. One member of staff said, " I have seen changes for the better recently" and another said, "It has got better here recently". This was attributed to the manager by staff.
When the manager was walking around the building with us we saw them speaking in a friendly way to people. They were interested in the people who used the service and responded appropriately when someone had a concern. People appeared to be relaxed around the manager and approached them frequently during our visit.
The service had a quality assurance system and records seen by us showed that there were some shortfalls identified that needed addressing.
When the manager had been alerted to a medication error she had followed the correct procedures and alerted the appropriate people. She had followed appropriate employment law procedures and taken advice when needed.