There were 27 people living in the home when we inspected. People in the home were living with enduring mental health conditions. Our inspection team was made up of two inspectors and an expert by experience all of whom considered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them, relatives and a social care professional and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
We found that the staff recruitment practices in place were now safe and ensured that people were only supported by people who had been properly recruited and assessed to care for them safely. However, there was no evidence that risk assessments or repeat checks had been made of staff who had been recruited prior to the new procedures being implemented and this may place people at risk.
We found that amongst all staff there remained an inadequate level of training and understanding on Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Not all staff who could be in charge of the home were aware of the latest legal ruling on DoLS. We also found that other staff had either no understanding or very limited training on how this legislation affected their day to day practice. This meant people may not be safeguarded as necessary.
We found that measures and steps to improve the management and support for people in respect of managing their finances had not improved sufficiently and that progress to introduce the changes was not being made at the expected pace.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to safeguarding the rights and finances of people living in the home.
We asked people about feeling safe in the home and we received a number of positive comments including: "They have done some works about the home. There are new windows and doors and a new fence as well." and "Things have changed there has been lots of decorating." The home was safe and clean and improvements made to bathrooms and toilets meant that people were not placed at risk whilst using these facilities.
We found that there were some areas of quality that needed to be addressed in ensuring good infection control.
Is the service effective?
We found that people's needs had been assessed. Records confirmed that people's preferences and needs had been recorded. However, there was little evidence to show that the care had been provided as required.
We did not see any daily written records by care staff. Although the system had the capability to pull together information about changes in people's needs this was not being used to review people's care.
Training records indicated that staff required further training to ensure that they could provide the skilled support that people needed.
We found that people were cared for by staff who were not supported to deliver care and treatment safely and to an appropriate standard.
Is the service caring?
We saw that care plans had improved and were more personalised than they had been. They contained useful information about a person's preferences in food and drink, their routines and interests as well as their health and social care needs. However we found people had not been fully involved in making decisions about their care and support needs and some decisions had been made about involvement of activities of daily living which limited people's independence.
We observed that care staff were kind and did interact well with people who lived in the home. However, we did not see much individual interaction with people during our observations other than when a task needed to be undertaken.
Is the service responsive?
Comments from people who lived in the service Included: "Staff are talking to me about decorating my bedroom," "They recently decorated my bedroom and they asked me what colours I wanted," This showed that staff had listened to people and carried out their wishes in this respect.
Records showed that meetings had been held to gain people's views and that people's interests and desired activities were part of these discussions. However, from meeting to meeting there was no record of any follow up to show that people's suggestions for activities had been acted upon.
We found that people's views were not being fully taken into account in relation to how the home was run.
Is the service well-led?
Improvement was needed in how records were maintained. Not all records were kept securely and a number of them could not be located promptly when needed.
The staff files were organised and presented in a variety of ways. There was no consistent presentation and there were prompts, such as dates, which had not been completed on all of the files we looked at. Computer records of people's finances were not updated in a timely way.
Improvements to activities in the home were not always being supported by the management of the home.
Staff had a clear understanding of their roles and responsibilities. However, we saw that the views of some members of staff had not been taken into consideration in the way the home was run.
We had concerns that the manager of the home had not kept people's financial records up dated.
There was not always evidence that the manager was taking account of complaints and comments to determine their next actions.
The provider confirmed that would not be admitting new people into the home until these concerns had been met.