The inspection team who carried out this inspection consisted of two inspectors to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.
If you want to see the evidence that supports our summary please read the full report.
Prior to our inspection we reviewed all the information we had received from the provider. We used a number of different methods to help us understand the experiences of people who used the service. We undertook conversations with six people who used the service and one person's relative. We spoke with representatives from the management team and four care staff. We also spoke with the activities coordinator, head chef, domestic assistant and nurse. We looked at some of the records held at the home which included people's care plans and supplementary documentation.
The home does not currently have a registered manager. A new manager has been appointed and we have been told they plan to have them in place by the end of July 2014. In the meantime, three people were covering the managerial duties, with a Quality Assurance Manager managing the home for four of the seven days per week. In terms of the content of this report, we have referred to this person as the manager. We will monitor this service and the new manager's application to become registered with the CQC.
Is the service safe?
Only nine of the forty three people who used the service had been involved in a review of the care plans. We were told by the manager that plans were in place to ensure the remaining people, and where appropriate their representatives, were involved in a review of the care.
People were cared for an environment that was safe, clean and tidy. Communal and garden areas were well maintained and people spoken with told us they were happy with the cleanliness within the home.
Some of the staff spoken with told us they did not regularly read people's care plans and therefore we could not be confident that people always received care and treatment appropriate to their needs. However we spoke with people who used the service and they told us they felt safe at the home. One person said, 'I feel safe, I have no issues. You couldn't want for a better place. My health has improved so much since being here.' Another person said, 'I am safe here, I feel so happy. I think this is a fantastic home, I wouldn't want to live anywhere else. They [staff] look after me so well, I don't want for anything.'
We could not judge whether staff were suitably skilled or qualified for their role. Staff training records showed gaps in some areas such as moving and handling, dementia and dignity awareness.
The CQC monitors the operation of the deprivation of liberty safeguards (DoLS) in place which applies to care homes. DoLS are part of the Mental Capacity Act 2005. Correctly applied DoLS make sure that people in care homes are looked after in a way that does not inappropriately restrict their freedom. The manager and staff could explain the principles of the DoLS and how they implement these safeguards into the role. The manager told us they would be assessing each person who used the service to establish whether a DoLS was required for them.
Is the service effective?
Staff gave people choices throughout the day and were patient in their approach.
We saw a person had been assessed as requiring their food and fluid intake to be monitored. However the records did not always reflect that this had been carried out
The food and drink provided for people was readily available, of a good quality and there was a wide range of food to choose from. The head chef requested people's feedback regularly and asked them what they thought of the food and drink.
People who used the service said, "You get plenty of choice of food. There are so many nice things to choose from. You can order your food the day before. It really is fantastic. I don't have to wait a long time for my food, it is there when I want it.'
Is the service caring?
We observed staff interactions with people who used the service and in the majority of occasions they were caring in their approach. However we did see one member of staff talk disrespectfully to a person who used the service, which was reported to the manager.
People who used the service spoke highly of the staff and responded well to them throughout the day.
Is the service responsive?
Staff responded to people's needs in a timely manner. They responded to call bells within a reasonable time frame.
However we saw a person was left for an unacceptable length of time to wait for their lunch as the stand aid required to assist them to the dining room was unavailable. They were left alone, for half an hour, before assistance was provided. We spoke with the person and staff and they assured us that this was a one off and did not happen regularly.
Is the service well-led?
There is not currently a permanent manager at the home, although we were told by the Quality Assurance Manager (QAM) that a new manager had been recruited and was due to commence employment soon.
People who used the service and staff told us they found the current manager approachable and were confident they would deal with any concerns or complaints that they had.
We saw some quality monitoring had taken place throughout the home, although the quality and review of the care plans was not sufficient. Additionally the regular monitoring of staff performance had not always taken place.