There were seven people living at the home during the inspection. We used a number of different methods to help us understand the experiences of people who used the service. This was because some of them had complex needs which meant they were unable to tell us about themselves.We met and spoke with six of the people, five staff and the regional manager. We observed five staff supporting six people.
We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found-
Is the service safe?
Overall, people had been cared for in an environment that was safe, clean and hygienic. There were infection control procedures and policies in place and staff had received training.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No new applications have needed to be submitted for one individual following the lapse of a previously approved application. Staff have received training in the Mental Capacity Act and managers understood when an application should be made.
Is the service effective?
We observed that people were relaxed with staff and gave them eye contact and smiles. Staff knew people well and understood their non-verbal communication and gestures. They were able to explain how they knew when people were happy, sad, uncomfortable, frustrated or in pain.
People had their needs assessed and care plans were in place. Staff understood people's complex health, learning disability and mobility needs.
People were encouraged to participate in the day to day living in the home and they were an active part of the local community.
Staff had received training to meet the needs of the people living at the home.
Is the service caring?
We observed that staff were kind and treated people as individuals. There were positive relationships between people and staff. People who were independently mobile actively sought the company of staff.
Staff encouraged people to be independent with eating and drinking. They were discrete and sensitive when people needed support with their personal care.
Is the service responsive?
People's needs had been reassessed since the last inspection and care plans included people's care needs and preferences. We saw in records that people had taken part in activities they enjoyed in the home and the community. People were supported to maintain relationships that were important to them.
People were referred appropriately to health or social care professionals and the guidance from these professionals was readily available to staff.
There were 'mental capacity act assessments' and 'best interest decisions' in place for people where needed. These decisions had been made by representatives, health and social care professionals involved with the individuals.
Is the service well-led?
There were quality assurance systems in place that ensured that the quality and safety of the home was kept under review. Action plans were put in place for any shortfalls identified.
Staff received mandatory and specialist training to be able to meet the complex needs of people living at The Tides. There was an ongoing training programme in place. There were staff meetings and staff received appraisals and one to one supervision.