15 November 2016
During a routine inspection
At the time of our inspection there was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At our last inspection on 16 and 23 February 2015, we found five breaches of the Health and social Care Act 2008 (Regulated Activities). These breaches were in relation to unsafe care due to poor moving and handling procedures, staff not following cleaning procedures to reduce the risk of infection, people not being secure in the premises and staff not being trained in safeguarding, staff members not receiving sufficient training, the registered provider had not offered meaningful activities for people living with dementia and that care plans were not individualised. The provider sent us an action plan stating that they had addressed the concerns raised.
At this inspection, we found that the provider had taken action on all these areas and was fully meeting the regulations where breaches were found.
The registered provider had systems in place to protect people against abuse and harm. The registered provider had effective policies and procedures that gave staff guidance on how to report abuse. The registered manager had robust systems in place to record and investigate any concerns.
Risks to people's safety had been assessed and actions taken to protect people from the risk of harm. The environment was clean and appropriate measures had been taken to reduce the risk of infection. Medicines were managed safely and people had access to their medicines when they needed them.
Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff met together regularly and felt supported by the manager. Staff were able to meet their line manager on a one to one basis regularly. There were sufficient staff to provide care to people throughout the day and night. When staff were recruited they were subject to checks to ensure they were safe to work in the care sector.
Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people's ability to make decisions for themselves had been completed. Where people's liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person's rights were protected.
People had enough to eat and drink, and received support from staff where a need had been identified. People's special dietary needs were clearly documented and staff ensured these needs were met.
The environment was designed and adapted to meet the needs of people who are living with dementia, through sympathetic re-decoration and usage of the building.
The staff were kind and caring and treated people with dignity and respect. Good interactions between people and their support staff were seen throughout the day of our inspection. Staff knew the people they cared for well and treated them with kindness, compassion, dignity and respect.
People could have visitors from family and friends whenever they wanted. People spoke positively about the care and support they received from staff members.
People received a person centred service that enabled them to live active and meaningful lives in the way they wanted. People had freedom of choice at the service. People could decorate their rooms to their own tastes and choose if they wished to participate in any activity. Staff respected people's decisions.
People felt well cared for and were supported with a variety of activities. However, activities were not always structured meaning that people could potentially become under stimulated. We have made a recommendation about this in our report.
Support plans ensured people received the support they needed in the way they wanted. Peoples health needs were well managed by staff so that they received the treatment and medicines they needed to ensure they remained healthy. Staff responded effectively to people's needs and people were treated with respect.
Staff interacted with people very positively and people responded well to staff. The culture of the service was open and person focused. The registered manager provided clear leadership to the staff team and was an active presence in the home.
Audits to monitor the quality of service were effective and embedded. They identified actions to improve the service and these had been carried out.