Archived: No 31 First Row

At this review, we set out to answer the key question; is the service safe?

We carried out a desktop review on 18 September 2014. A desk top review considers information only and did not require a visit to the service.

There was one person living at the service at the time of our review. We did not speak with this person since we used other methods to assess whether the provider was now meeting the regulations. We reviewed the provider's action plan and the person's care records and spoke with the provider's representative, the registered manager and a care manager from the local NHS Trust.

We found that improvements had been made and considered that appropriate systems were now in place to ensure the person was protected against the risks of receiving care or treatment that was inappropriate. We found the recording systems were improved and provided detailed information about the delivery of care and support.

' 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.

Is the service safe?

There was one person living at the home on the day of our inspection.

The provider had systems in place that identified, assessed and managed risks to the health, safety and welfare of the person who used the service and others.

We noted that the person's records had not been fully updated to reflect their current care needs. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

The staff we spoke to were all aware of the complaints, safeguarding and whistle blowing procedures. All of the staff said they would immediately report any concerns they had about poor practice and were confident these would be addressed.

We found the house was clean and the person was protected by the systems in place to reduce the risk and spread of infection. We saw staff were provided with appropriate training to equip them with the skills to meet the person's needs.

Is the service effective?

There were systems in place to ensure the person's health and care needs were assessed with them. We found they were involved in this process. However, we saw that specific care plans were not in place for the individual's particular nutrition needs. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Staff training was provided that took account of the needs of the person in the house. For example, we saw training in administration of medicines and challenging behaviour had been provided.

Is the service caring?

We saw staff responded kindly and respectfully to requests from the individual. There was a relaxed atmosphere and we saw there was a good rapport between the person and staff. The person told us, 'The staff are great and I like the house. I am comfortable and I can choose what I want to do.'

The person's preferences, interests, and diverse needs had been recorded, but were not fully recorded in the current care plan. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service responsive?

The individual told us they were aware of the complaints procedure and staff could describe how they would assist them to make a complaint. We saw there were systems in place for dealing with and recording complaints.

Staff were aware of safeguarding and whistleblowing procedures and could describe the action to be taken in the event of a safeguarding referral being made.

Is the service well led?

The service had a quality assurance system in place that included the use of surveys from the person who used the service. This meant the individual was able to feed back on their experience and the service was able to learn from this.

Staff had regular supervision and staff meetings which meant they were able to feedback to the management of the home their views and suggestions.

The manager confirmed their views were listened to and account was taken of them. They said they felt well supported by the provider and their representative.

The person living at the home was offered a range of food and drinks. Their individual choice or foods was respected and catered for, as far as practicable. We found that there was a range of food and goods in store, which included fresh vegetables.

Accommodation was provided across a single storey and key facilities such as the kitchen are and wet room were easily accessible. The person's bedroom was individually decorated. The person using the service told us they liked their bedroom.

We found evidence that proper staff recruitment and selection processes were being followed. Appropriate checks were being undertaken before people started working at for the service.

We noted that regular supervision and appraisals meetings were not taking place to ensure staff could discuss any concerns or training needs.

We found records were up to date and issues such as professional involvement or doctor's appointments could be crossed referenced. Daily records were up to date and included details of activities, meals and any issues of note.

We observed people were asked for their opinion and about what they wanted to do and the provider acted in accordance with their wishes. Staff checked with people they were happy for us to examine their personal files and for us to view their bedroom.

We established people in the home had comprehensive assessments of their needs, detailed care plans and that risk assessments had been undertaken. These highlighted important aspects of their care needs.

We saw medicines were stored securely in a locked cupboard and signatures were in place to indicate that a medicine had been given. We saw that there were regular audits of the medication and the recording systems and that medicines were checked when they were delivered to the home or disposed of.

We saw that there was an up to date training record for all staff. This indicated the range of courses that had been undertaken and the dates that training needed to be renewed. Staff told us that they had regular supervision meetings and yearly appraisals with senior staff to discuss their work.

We saw the home had a written complaints procedure that detailed the process to be followed in the event of a complaint. This indicated that complaints should be documented, investigated and responded to within a set timescale. We saw that there were pictorial questionnaires that people using the service had completed.