The inspection was carried out by an adult social care inspector. An Expert by Experience was part of the inspection team. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. During the inspection evidence was gathered to answer five key questions; is the service safe, effective, caring, responsive and well-led?As part of this inspection we spoke with nine people who use the service, one relative, one health professional, the registered manager, and seven care staff. We looked at records relating to the management of the home and five people’s care 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?
We found the service was safe. People told us they felt safe. One person said, “I feel I am in safe and kind hands.” Staff had a clear understanding of their responsibilities to report abuse and all staff we spoke with had received safeguarding vulnerable adults training.
People’s needs were assessed and care plans reflected their identified needs. We saw that where risks were identified these had been assessed and appropriate action taken. For example, where people were at risk of pressure damage, pressure relieving equipment was in place in line with their care plan.
There were sufficient staff on duty to meet people’s needs. We observed staff responding in a timely manner to any requests for support. People told us their call bells were answered promptly. Staff showed a good knowledge of the needs of the people they were supporting.
The provider understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager was aware of the recent Supreme Court judgement in relation to the Deprivation of Liberty Safeguards and would take appropriate action if a person required a DoLS.
Is the service effective?
We found the service was effective. People were supported in a dignified and respectful manner. We saw that care records were person centred and written with the involvement of the person and their families.
People’s cultural and spiritual needs were identified. We saw people being supported to attend Holy Communion in the home. Two people told us their faith was important to them and were grateful to have the opportunity to take Holy Communion and go to church.
People were supported to maintain and improve their independence. We observed people being encouraged to carry out activities. For example, during the book club meeting the activity coordinator supported people to read passages of the book in a reassuring manner. One person’s care record identified they were now able to feed themselves with support having previously been dependent on care staff. We observed this person being encouraged to feed themselves.
Is the service caring?
People told us they felt well cared for. One person told us, “Staff are absolutely marvellous, very caring.” Another said, “I feel that all the staff are caring.”
People were supported by caring and attentive staff. We saw care workers encouraging people with patience and understanding. People were not rushed and were able to do things at their own pace.
People were supported in a timely manner, with dignity and respect. For example, one person was being transferred from their wheelchair to an arm chair using a hoist. This was done with care and reassurance.
Is the service responsive?
The service was responsive to people’s needs. Where changes in people’s needs were identified appropriate support from health professionals was sought and changes to care needs met. For example, where care records showed people had been assessed as at risk of choking they had been referred to the speech and language therapist (SALT). The recommendations made had been implemented and we saw people receiving the correct consistency of fluids.
The home took account of complaints in order to improve outcomes for people. One person's relative had complained about the lack of physiotherapy support for their relative. This was reviewed by the home manager and additional support provided.
Is the service well-led?
The service was well-led. The provider had systems in place to monitor the quality of the service. Annual surveys were conducted to gain the views of people using the service and their relatives. We saw that comments from the survey had resulted in actions being taken to improve the service. For example the survey showed that relatives felt communication between relatives and the home manager could be improved. This resulted in the manager relocating their office to the main building, nearer to the entrance.
There was a clear procedure for recording incidents and accidents. Any incidents and accidents relating to people who used the service were recorded centrally by the manager and then filed in peoples care records. The manager checked all incident forms to identify any risks or trends and what changes might be required to make improvements for people who used the service.