When we inspected the service in September 2013 we asked the provider to make some improvements. We went back on these visits to see what improvements had been made and also to look at some additional outcomes following information we had received about the service.During our SOFI observation we found that when staff engaged with people the interactions were positive. However, we noted that there were a lot of missed opportunities when staff didn't involve people. For example, when serving food and drinks.
We spoke with 20 people who used the service, five relatives, two district nurses, a social worker, care home liaison nurse and 10 members of staff. These were some of the things they told us:
'I am very happy here, the food is good and the staff are lovely. If I did have any concerns I would go to the desk and tell whoever was on duty.'
'I can choose where I spend my time I like to stay in my room but go downstairs to join in with the activities.'
'I have lived her for four years and I haven't got any complaints.'
'Everyone is very nice, helpful and doing everything they can to make me comfortable.'
'I am very happy here the staff look after me very well.'
'I am always made to feel welcome when I visit and the food is very good, especially the fresh cream scones!'
'I am very impressed with the home.'
'It's the best quality of life my relative could have.'
'I have been involved in the care plan and talked to staff about what my relative needs.'
'It's a nice place to work, we have a good team and the managers are very supportive and approachable.'
'We provide good care and work as a team. We have residents/relatives meeting and staff meetings to discuss issues.'
We found that generally staff treated people with respect, were patient and responded to people's requests.
There was no documentation in place to assess people's ability to make their own decisions or who should be involved if decisions about their care and support needed to be made in their 'best interest.'
People's care and support needs were being met and there were a range of activities on offer to help keep people stimulated.
Staff were aware of the different types of abuse that could happen. When incidents had occurred staff had made appropriate referrals to the safeguarding team.
We found the home was clean and tidy and staff were following infection prevention guidance.
We looked at the medication system and found that it was being managed safely and people were getting their medication at the right times.
We looked at the homes statement of purpose and found that it did not reflect the service that was being provided when we visited.
We found there was a complaints procedure in place but concerns and complaints were not always being documented. We also found that staff were not always going back to the complainant to see if they were happy with the outcome.
Care records were not detailed and not always up to date meaning that people could be at risk of receiving unsafe care.