3 November 2016
During a routine inspection
At the previous inspection in May 2015 we found the registered person had not ensured that people received all the nursing and health care they required. We reassessed this in May 2016 and found that whilst improvements had been made these changes were not embedded in practice and did not always ensure people received effective care. We told the provider they must take action to ensure people received effective health care. At this inspection we found that action had been taken and people were receiving effective personal and nursing care.
Also at the previous inspection in May 2015 we found that an effective system to regularly assess and monitor the quality of services provided was not in place and that procedures to protect people’s legal rights were not followed. The provider sent us an action plan telling us how they would improve. At this inspection we found that action had been taken and effective quality monitoring systems and procedures to ensure people’s legal rights were in place.
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.
There were not always enough staff to ensure people’s needs were promptly met and call bells were not always responded to in a timely manner. Recruitment practices had not ensured that all pre-employment checks were completed before new staff commenced working in the home. Staff received appropriate training and were supported in their work.
People were positive about the service they received. They were also positive about meals and the support they received to ensure they had a nutritious diet and about the activities available. People were supported and encouraged to be as independent as possible and their dignity was promoted.
People felt safe and staff knew how to identify, prevent and report abuse. Legislation designed to protect people's legal rights was followed correctly. Staff offered people choices and respected their decisions. People and visitors’ views about the service were sought in a formal and informal way and were acted on.
Care plans provided comprehensive information about how people wished to be cared for and staff were aware of people's individual care needs and preferences. Reviews of care involving people were conducted regularly. People had access to healthcare services and were referred to doctors and specialists when needed.
Medicines were managed safely and people received these as prescribed. At the end of their life, people received appropriate care to have a comfortable, dignified and pain free death.
People and relatives were able to complain or raise issues on a formal and informal basis with the registered manager and were confident these would be resolved. This contributed to an open culture within the home. Visitors were welcomed and there were good working relationships with external professionals.
Staff worked well together, which created a relaxed and happy atmosphere that was reflected in people's care. Plans were in place to deal with foreseeable emergencies and staff had received training to manage such situations safely.
Quality assurance systems were in place using formal audits and through regular contact by the provider’s representative and registered manager with people, relatives and staff.