We received information of concern regarding the training and support provided to members of staff, the levels of care a person had received and about how the service was operated and managed.The Inspector gathered evidence in response to the concerns raised and to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring, Is the service responsive? Is the service well led?
Below is a summary of what we found based on the evidence gathered during our inspection carried out on 27 June 2014. This included speaking with people who used the service, some of their relatives and members of staff who supported them and by looking at records.
The detailed evidence that supports our findings can be read in the full report.
Is the service safe?
We looked at care records that related to four people who used the service. We saw that proper steps had been taken to ensure that people were protected against the risks of inappropriate or unsafe care and support. This was because people's needs had been assessed and care had been planned and delivered in a way that met those needs and ensured their welfare and safety.
Is the service effective?
We saw that risk assessments had been completed and regularly reviewed in relation to a range of issues relevant to people's care needs and personal circumstances. These included moving and handling requirements, skin and pressure area care and the management of people's medicines.
Suitable arrangements were in place to ensure that staff were appropriately trained and supported to perform their roles. For example, we saw that a comprehensive induction programme, based on nationally recognised standards, was used to train and develop all members of staff. This meant that people who used the service were safe and had their health and welfare needs met by competent staff.
Is the service caring?
We spoke with people who used the service and some of their relatives who were all very positive about the levels of care and support provided. They told us that staff were normally punctual and stayed for the agreed length of time. One person said, 'They [staff] are always on time and are very good people. I have no complaints at all, the staff I have are always kind and caring. They have got to know me well and how I like things done.'
Is the service responsive?
Care records showed that people's needs, preferences and support plans had been documented, reviewed and updated to reflect people's changing needs and personal circumstances. They were personalised and gave staff good guidance about the care and support people needed. This included detail about people's daily routines, medicines, personal care, nutrition, mental health and continence needs.
Is the service well led?
We saw that risk assessments had been completed and reviewed in relation to a range of issues relevant to people's care needs and personal circumstances. These included skin and pressure area care, mobility and the environment. This meant that people who used the service had experienced effective, safe and appropriate care and support that met their needs.
The provider had systems in place to assess and monitor the quality of services provided and to identify, assess and manage risks posed to the health, welfare and safety of people who lived at the home.
A relative of a person who used the service told us, 'When I did contact the office about a concern about a particular carer [member of staff] they were excellent and very responsive to our concerns, genuinely very kind and caring. They made sure that carer was not used for [relative] again.'
This meant that the service was well led and people benefited from safe quality care and support due to effective quality assurance, decision making and management of risks.