An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?As part of this inspection we spoke with five people who used the service, the providers, three members of staff and a visiting GP. We also reviewed records relating to the management of the home which included, six care plans, daily care records, training records, support/supervision records of staff, quality surveys and audits.
Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.
Is the service safe?
During our inspection we spoke with five people who used the service. They told us that they were happy with the care and support provided. One person told us that, "I feel very safe and secure here knowing I will be well looked after and all my (health) problems taken care of." Another person said, "I feel very safe, I trust all of the staff."
We looked at six sets of care records which included individual risk assessments. Measures had been put in place to minimise any risks to people who used the service that ensured they were supported safely. For example, risk assessments were in place to ensure that the environment in which care was provided was safe, that medication was safely administered and that people who needed to be moved with a hoist were transferred safely.
Risks to people's health and well-being through malnutrition, falls or pressure ulcers were assessed and minimised.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. While no applications had needed to be submitted, policies and procedures were in place and under review. Relevant staff had been trained to understand when an application might be necessary and how to submit one.
We discussed staffing rotas which showed that there were sufficient numbers of trained and competent members of staff employed to provide people with safe and appropriate care as identified in their assessment and care plans.
Is the service effective?
People who used the service were treated with dignity and respect.
People who used the service were supported in making choices. For example, what to wear or what main meal they preferred. One person we spoke with said, "The food is great, but if you don't like what is on offer, they will always offer you something that is not on the menu." Where people found it difficult to make choices for themselves, staff supported them in making decisions based on 'best interest' principles. We spoke with five people who used the service. Four of the people we spoke with told us that staff discussed their care plans with them, two others were unsure.
Quality assurance measures were in place to identify the effectiveness of the service. This included questionnaires given to people who used the service, relatives and staff. We saw the results of a recent quality survey which showed that people who used the service and their relatives thought the service was effective.
Is the service caring?
We saw that people were cared for in an appropriate manner. Records we looked at showed that people's needs had been assessed and details of likes, dislikes, routines and preferences were recorded.
During our inspection we spoke with five people who used the service. People we spoke with who used the service were happy with the care and treatment they received. One person said to us, "It's marvellous here, I couldn't wish for any better." Another person said, "They look after me really well." A third person we spoke with said, "They know about me and they know about my problems. They asked me all about this when I moved here."
We looked at six sets of people's care records. These detailed their care and treatment.
Is the service responsive?
The six care records we looked at showed that people's needs, choices and personal preferences had been assessed and planned for. Records we looked at during our inspection detailed the needs of each person and their individuality.
People's health and social care needs were attended to. Information was available to staff about individual medical conditions to ensure that staff had up to date knowledge and were able to respond to the person's needs.
Is the service well-led?
There were monitoring and reviewing systems in place to ensure that the quality of the care and support provided was high. We spoke with three members of staff who told us that they had the training and support they needed to safely do their job, which they said they enjoyed.
Members of staff and family members of people, who used the service, were provided with opportunities to make suggestions and comments to improve the quality of people's support and care. These were developed into an action plan which identified the improvements made and ensured that the service was able to confirm when required improvements were completed.
Records we looked at showed that staff received regular support and supervision. This included an annual appraisal and three monthly spot checks to assess them in a practical setting whilst with people who used the service.
The providers managed the service themselves and spoke to people who used the service every day. This ensured that they were immediately aware where there were concerns and acted to address those concerns. Accidents and incidents were analysed to establish where measures could be put in place to prevent similar things occurring or to identify patterns. Where necessary support was provided by other health professionals and training