20 March 2019
During a routine inspection
People’s experience of using this service:
People told us they felt safe; however, we found people were not always protected from risks associated with their environment, medicines management and potential risks to people's health and welfare had not always been assessed.
People were not always protected by safe recruitment processes. The provider had not always obtained the necessary pre-employment checks before new staff started working at the service.
Systems and processes to monitor the service had either not been established or operated effectively to assess, monitor and mitigate the risks to people's health, safety and welfare. The provider’s quality assurance processes did not identify the issues we found at this inspection. These included concerns with the safety of the environment, risk management, recruitment and medicines management.
There was a risk that people's rights were not protected because staff did not always act in accordance with the Mental Capacity Act 2005 (MCA). Where people's capacity was in question MCA assessments were not always taking place and best interests decision processes had not always been followed.
Improvements were needed to ensure the service met the needs of people living with dementia. There was a lack of signage to help people living with dementia find their way around the home. People's bedrooms were not easily identifiable with nothing displayed on their doors. We made a recommendation to the provider about this.
People were supported by staff who had completed a range of training to meet their needs. Staff told us they felt well supported by the management team. The management team monitored staffs’ practice through regular observation but did not have a system of formal supervision meetings. We made a recommendation about this.
People received personalised care from staff who knew them well and understood how to meet their needs. Care plans contained information about individual preferences and what was important to people such as interests and activities. However, during the inspection we observed people were not engaged in meaningful activity and there was no information displayed within the home about activities on offer. We made a recommendation to the provider to review their activity provision at the service.
People and their relatives felt staff were kind, friendly, and attentive to their needs. We observed warm interactions and people were treated with kindness and care by staff. One person said, “I feel like one of the family. I am one of the family!” Another person said, “Staff look after us ever so well.”
People's privacy and dignity was respected, and their independence promoted.
People had access to healthcare professionals when required and were supported to maintain good healthcare. Health professionals we spoke with told us they were happy with the quality of care and engagement from the service.
Rating at last inspection: At the last inspection the service was rated Good (report published 18 October 2016).
Why we inspected: This was a planned inspection based on previous rating.
Enforcement: During this inspection we found four breaches of regulation. Action we told provider to take can be seen at the end of full report.
Follow up: We will carry out ongoing monitoring of the service and check the improvements have been made at our next inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk