The inspection was carried out by one inspector, who answered the five 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. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.
If you would like to see the evidence supporting our summary please read the full report.
Is the service safe?
We found the service to be safe because people were treated with respect and dignity by the staff.
When people were at risk, staff followed effective risk management policies and procedures to protect them. Staff supported people to take informed risks with minimal necessary restrictions to as far as possible, protect their welfare.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
The service understood the requirements of the Mental Capacity Act 2005, its main Codes of Practice and Deprivation of Liberty Safeguards, and put them into practice to protect people. The manager was in the process of re-assessing the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) for people who use the service and was having discussions with local authorities about this. This meant that people were protected from discrimination and their human rights were protected.
The service followed safe recruitment practices. The service followed clear staff disciplinary procedures when it identified unsafe practice.
Is the service effective?
We found the service to be effective because there was an advocacy service available if people needed it. This meant when required people could access additional support to make decisions.
Care plans reflected people's current individual needs, choices and preferences. People's health was regularly monitored to identify any changes that may require additional support or intervention. Referrals were quickly made to health services when people's needs changed.
People we spoke with said, 'Staff are excellent, they really are' and 'Staff are brilliant.' A visiting health care professional person told us, 'Staff are excellent. I have no worries about the home, it's very good'
People's choices for end of life care were respected by staff. People had access to the specialist palliative care services they needed. People had the equipment they needed to meet their end of life needs.
Is the service caring?
We found the service to be caring because people were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. Staff responded in a caring way to people's needs when they needed it.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. Appropriate professionals were involved in planning, management and decision making.
Staff knew the people they were caring for and supporting. People were as independent as they wanted to be.
Is the service responsive?
We found the service responsive because, where appropriate, a person's capacity was considered under the Mental Capacity Act 2005. When a person did not have capacity, decisions were always made in their best interests. Advocacy support was provided when needed.
People had their individual needs regularly assessed and met. There were arrangements in place to speak to people about what was important to them.
People, and those that matter to them, were encouraged to make their views known about their care, treatment and support.
Emotional support was available to people, their families, friends and staff.
Is the service well-led?
There was a registered manager in post on the day of our visit and all other conditions of registration were met. The registered manager understood their responsibilities and was supported by senior management to deliver what was required.
The service worked well with other agencies and services to make sure people received their care in a joined up way.
The service had an effective quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result, the quality of the service was continuingly improving. Robust quality assurance and governance systems were in place and used to drive continuous improvement.
People told us, 'I'm quite sure my opinions are listened to' and 'They listen to all of us, they're very good like that.' One relative told us, 'We can make suggestions. They keep you informed if there are any events going on.'
There were effective arrangements to continually review safeguarding concerns, accidents and incidents.
Emergency plans were in place and understood by all staff. Staff knew and understood what was expected of them.