8 November 2016
During a routine inspection
There was a manager in post who had submitted an application to the Care Quality Commission to be registered as the manager for the service. The registration requirements for the provider stated the home should have a registered manager in place. 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 the last inspection on 15 & 16 July 2014, we found the service was meeting the regulations that were applicable at the time.
During this inspection we found the service was meeting the current regulations.
People using the service told us they felt safe and well cared for. People had mixed views about the staffing levels but considered there were enough staff to support them when they needed any help.
The manager followed a robust recruitment procedure to ensure new staff were suitable to work with vulnerable people.
The staff we spoke with were knowledgeable about the individual needs of the people and knew how to recognise signs of abuse. Arrangements were in place to make sure staff were trained and supervised at all times.
Medicines were managed safely and people had their medicines when they needed them. Regular checks on the management of medicines were carried out and action taken where shortfalls were identified. Staff administering medicines had been trained to do this safely.
Risks to people’s health and safety were identified and measures had been put into place to mitigate these risks. We asked the manager to carry out a risk assessment on the use of specialist high dependency easy chairs designed for people’s comfort as a safety precaution. These were being used by staff and relatives to the same effect as a wheelchair.
We found the premises to be clean and hygienic and appropriately maintained. Regular health and safety checks were carried out and equipment used was appropriately maintained.
Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions for themselves. Staff understood the importance of gaining consent from people and the principles of best interest decisions. Routine choices such as preferred daily routines and level of support from staff for personal care was acknowledged and respected.
People using the service had an individual care plan that was sufficiently detailed to ensure people were at the centre of their care. Care files included ‘My day, My life’ profile of people’s needs that set out what was important to each person.
People’s care and support was kept under review, and people were given additional support when they required this. Relevant health and social care professionals provided advice and support when people’s needs had changed.
We found staff were respectful to people, attentive to their needs and treated people with kindness in their day to day care. Care plans were written with sensitivity to reflect and to ensure basic rights such as dignity, privacy, choice, and rights were considered at all times.
Activities were varied, interesting and appropriate to individual needs. Links with the local community were good and being further developed.
People were provided with a nutritionally balanced diet that provided them with sufficient food and drink that catered for their dietary needs.
People using the service and relatives told us they were confident to raise any issue of concern with the registered manager and that it would be taken seriously and the right action taken.
People using the service, relatives and staff considered the management of the service was very good and they had confidence in the manager.
There were systems in place to monitor the quality of the service to ensure people received a good service that supported their health, welfare and well-being. Audits were completed regularly and the outcomes were monitored and reviewed.