An inspector and an inspection manager took part in this inspection. As part of our inspection we spoke with three people who used the service, the relatives of two people using the service, a visiting professional and five members of staff working at the service, including the manager. 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?
We found that although nobody using the service was under a Deprivation of Liberty Safeguard (DoLS) at the time of our inspection, appropriate applications had been made by the service in the past. However, people's mental capacity was not being considered by the service.
We found that people were being cared for in premises which were being maintained to ensure their safety. We found the premises to be safe and secure for people. However, we did not find the premises to be in a clean and hygienic state at the time of our inspection.
People's risks associated with their care were being managed effectively and people were being cared for by adequate numbers of staff.
Is the service effective?
People were involved in their care planning and delivery on an on-going basis. People's individual likes and dislikes were detailed within their care plans and staff understood people's care needs. However, care plans did not always contain the relevant information and accurate records were not being held for people.
People's health needs were being monitored and the relevant health professionals were involved in their care.
People told us that they liked living at the home. One person told us, 'I'm happy with everything.' Another person said, 'The food is beautiful.'
Staff did not have adequate training to effectively meet the needs of people using the service. There were gaps in staff training in relation to safeguarding vulnerable adults and infection control, amongst others.
Is the service caring?
We observed staff to treat people with respect and maintain their dignity. Staff were kind and compassionate towards people. Staff knew the people they were caring for and we saw that people's personal histories were detailed in their care plans.
People were able to express their views about how the service was run through regular meetings and people were asked about how they wanted their care to be delivered to them. One person using the service told us, 'Anything you want them to do they'll do it for you.'
Is the service responsive?
There had been no mental capacity assessments carried out for people who may have lacked the capacity to consent to their care. People's consent was not being obtained at the service and therefore it was not clear how people were agreeing to their plan of care.
People had access to some activities and did not appear to be at risk from social isolation. There were systems in place to obtain people's views about how the service was being run.
People's individual needs were assessed on a regular basis, however, some people's care records were in need of review and updating and some records held for people were not being adequately kept.
Is the service well-led?
There had been a recent change of manager at the home and the current manager had submitted an application to us, the CQC, to become registered at the service. The service was found to be continuing to fail to meet the requirements detailed in this report. We have asked the current manager to make the required improvements within a short timeframe due to continued failings at the service.
We found that although some quality assurance processes were now in place and being carried out effectively, staff training and infection control was not being monitored and addressed at the service. Staff required training in a number of areas and the home was not found to be clean or hygienic at the time of our visit.
Staff, relatives and a visiting professional spoke positively about the new manager in place at the service and told us that this had made a positive difference to how the service was being run.