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 safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Below is a summary of what we found. It is based on our observations during the inspection, speaking with people who used the service; the staff supporting them and from looking at a range of records.
SAFE
We found that there were enough staff on duty to ensure that people's needs were met safely and in a timely way. One relative commented, 'There's at least two staff on and whenever mum needs the loo, they're there quickly'.
Most staff had received recent training in the Mental Capacity Act 2005 so that they understood their responsibility when supporting people who could not make decisions for themselves. We found that people's mental capacity had been monitored regularly to determine whether or not they were able to make decisions for themselves.
Potential risks to people had been identified and recorded clearly in their plans of care. We saw that these risks had been reviewed regularly to ensure that people were kept safe.
We found that the cleanliness issues identified during our previous inspection in October 2013 had been fully addressed by the provider. However, we noted a number of new issues during this inspection which compromised good infection control and put people at unnecessary risk of infection. In light of this, we have decided not to take further enforcement action in light of the continued breach of the regulations, but to issue another compliance action on this occasion. We were confident that the new manager would take the required action to improve levels of cleanliness in the home's laundry.
EFFECTIVE
We found that people's health and well-being had been closely monitored and that they received good support both from the staff team and from a range of external health care professionals. Staff were now receiving supervision, support and training to enable them to meet people's needs more effectively.
CARING
One GP told us, 'A lot of the staff live locally and have known the residents personally and so are very caring of them.' We noted that people looked well cared for, were dressed appropriately and showed good signs of emotional well-being and activity throughout our visit. Staff treated people respectfully and with dignity.
People's relatives had been involved in their care where appropriate, and were kept informed by staff of any changes to their family member's care.
RESPONSIVE
People told us that staff were readily available and responded to their requests for help when needed. Throughout our inspection we saw that people's requests for assistance were met quickly by staff.
Health care professionals told us that they received appropriate referrals from staff at the home and that staff were good at spotting and responding to people's potential health problems.
We found that people's complaints were thoroughly investigated and responded to in an open and professional way.
WELL-LED
A new manager had recently been appointed for the home and was in the process of submitting her application to be registered with us. She is an experienced manager and qualified nurse, who has previously been registered with us. Although only in post five weeks, she had already implemented a number of changes for the better and had a clear vision of how the home could be improved further. Staff had confidence in the new manager's abilities and reported that their morale had improved as a result. We noted that staff supervision, training and support had increased since her arrival.
We found that there were a number of systems in place to monitor and assess the quality of service provided to people. However, the provider may wish to note that these had been ineffective in identifying serious infection control and hygiene issues in the home's laundry.