An adult social care inspector carried out this this inspection on 02 and 03 July 2014. 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 six people who used the service, two healthcare professionals who had regular contact with the home, contracts monitoring officers from the Local Authority, the manager and five members of care staff. We reviewed records relating to the management of the service which included five care plans, daily records, medication records, safeguarding procedures, training records and quality assurance monitoring records.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at
Is the service safe?
Risk assessments regarding people's individual needs and activities were carried out and arrangements were in place to minimise any potential dangers as much as possible. However, we saw that improvements were needed as some risk assessments lacked detail and were not cross referenced to people's care plans. It was not clear how people had been involved in the preparation of their care plan and we did not see any document to evidence that they were in agreement with their care and support to be provided. Improved monitoring of medication needed to be in place to ensure that people safely received their prescribed medication and that the provider had the required amounts of medication in stock.
These issues showed that people could not be sure that their care and support needs were agreed and were being safely met at all times.
Is the service effective?
Observations we made during our inspection confirmed that the people using the service care were assisted to make choices regarding how they wished to spend time during the day either at home or going to local facilities in the community. People met with with staff to discuss activities and plans for the forthcoming week. We saw that staff assisted people to become more confident in the preparation of meals and financial budgeting. The care staff we met were knowledgeable about people's individual care and support needs and they had also received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) so that appropriate arrangements were in place so that people were protected. However, it was not clear how people had been involved in the preparation of their care plan and we did not see any document to evidence that they were in agreement with their care and support to be provided.
Is the service caring?
Observations made during our inspection showed that people received warm, consistent and respectful support from care staff and they were enabled to make choices and changes when required. Observations we made during our inspection confirmed that the care staff provided friendly and attentive support when assisting people during the day. One person told us that, 'I really like living here and the staff help me with going out shopping and keeping my flat tidy.' Staff told us that they were well supported by the new manager and their colleagues so that they could provide safe care and support to people.
Is the service responsive?
We saw that the manager and care staff were attentive and responded to people's queries and concerns in a friendly and respectful manner. However, we saw that people's personal care and social support needs were not always accurately recorded and accompanied by an appropriate risk assessment. It was also not evident, from care records that we saw, how people had been involved in the reviewing and planning of their care and support.
Is the service well led?
The home does not have a registered manager in place. However, a manager has been appointed and has been in post since May 2014. The manager told us that they were submitting an application to become registered with the Care Quality Commission. The staff told us that they felt well supported by the new manager and were regularly trained to provide care and support. Observations made during our inspection showed that staff were enthusiastic, friendly and attentive to ensure that people were supported throughout the day.
However, it was evident from a number of concerns that we had regarding care and support, daily care records, medication administration and ongoing monitoring that quality assurance procedures were still not effective to ensure that people received a good service.