1 November 2016
During a routine inspection
The service provides accommodation, nursing and personal care for up to 56 older people who may live with dementia. Fifty-one people were living at the home on the day of our inspection.
The registered manager had been in post for almost three years. A registered manager is a person who has registered with the Care Quality Commission 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.
At our previous inspection in November 2015, we found a breach of the regulations, related to the number of skilled and experienced staff in post, which had an impact on all of the five questions we ask about services. We gave the home an overall rating of requires improvement and asked the provider to send us a report, to tell us how improvements were going to be made to the service. At this inspection, we checked whether the actions they had taken were effective.
Since our previous inspection, the registered manager had recruited additional staff. There were enough skilled and experienced staff on duty to meet people’s care and support needs safely and effectively.
The registered manager checked staff’s suitability to deliver care and support during the recruitment process. The premises were regularly checked to ensure risks to people’s safety were minimised. People’s medicines were managed, stored and administered safely.
People were safe from the risks of harm, because staff understood their responsibilities to protect people from harm and were encouraged and supported to raise concerns under the provider’s safeguarding and whistleblowing policies.
The registered manager assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks. Accidents, incidents and falls were investigated and actions taken to minimise the risks of a re-occurrence.
People’s needs were met effectively because staff had the necessary skills and experience and received appropriate training and support. Staff understood people’s needs and abilities because they worked with experienced staff until they knew people well. Staff were encouraged to reflect on their practice and to develop their skills and knowledge, which improved people’s experience of care.
The registered manager understood their responsibility to comply with the requirements of the Deprivation of Liberty Safeguards (DoLS). They had applied to the Supervisory Body for the authority to restrict people’s rights, choices or liberty in their best interests.
People were offered meals that were suitable for their individual dietary needs and met their preferences. They were supported to eat and drink according to their needs. Staff ensured people obtained advice and support from other health professionals to maintain and improve their health.
People were cared for by kind and thoughtful staff who knew their individual preferences for care and their likes and dislikes. Care was planned to meet people’s individual needs and abilities and care plans were regularly reviewed and updated when people’s needs changed.
Staff were guided and supported in their practice by a management team that they liked and respected. Quality audits included reviews of people’s care plans and checks on medicines management and staff’s practice.
Some improvements had been made in record keeping since our previous inspection, but further improvements were needed. Individual records were not completed consistently or sufficiently detailed to evidence that staff took the necessary actions to minimise risks to people’s treatment and care. Audits of people’s care and treatment needed to be more robust.