30 January 2018
During a routine inspection
At the last inspection in January 2016 the service was rated requires improvement in safe domain and rated Good overall.
At this inspection we found the service improved, was Good in all areas and rated as Good overall.
There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
During our last inspection we found concerns around medicines stock control and that some of the topical medicines, cream, had no opening date recorded which meant it was not always clear whether these topical medications were still safe for use. At this inspection we found the provider addressed these concerns and the medicines were managed, stored and administered safely.
People remained safe at the service. Staff knew how to recognise safeguarding concerns and what to do if they suspected any abuse. The provider had relevant safeguarding policies and systems in place and the staff were familiar with the local authority’s safeguarding procedures.
Risk assessments were carried out to promote people’s well-being and recognise people’s individual abilities. The environment was clean and well maintained and staff adhered to infection control guidelines.
There were enough staff to keep people safe and people were assisted promptly and without unnecessary delay. The provider followed safe recruitment procedures. Staff were knowledgeable, skilled and had the relevant skills and experience. Records confirmed staff received regular supervision sessions and they told us they were well supported.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s rights to make their own decisions were respected.
People were supported to access health professionals when needed and staff worked closely with various external professionals to ensure people’s health needs were met. The service remained responsive to people's needs and ensured people’s changing needs were recognised and appropriate changes to support were implemented promptly. People knew how to complain but told us they never needed to as any small concerns were being addressed promptly.
The service continued to support people in a caring way. People were treated with kindness and as individuals. People were involved in decisions about their care needs and the support they received. People’s dignity, privacy and confidentiality were respected, and they received person centred care that included access to information that met their needs.
The service was well-led by an experienced and motivated registered manager who ensured staff put people at the forefront of the service delivery. There was an open and positive culture that valued and engaged people, relatives and staff. The registered manager had good systems to monitor the quality of the service provided and ensured new ideas were explored to sustain high standards. The service worked well with various external professionals who were very positive about how the service was run.