17 December 2015
During a routine inspection
A registered manager was in post at the time of our inspection visit. 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.
We observed people attract staff attention and their behaviour indicated they welcomed these interactions. The staff knew the types of abuse and the expectations that they report any suspicions of abuse. Safeguarding procedures were on display and described the actions to be taken and included the contact details of agencies for staff to report allegations of abuse.
Arrangements were in place to manage risk. Where risks were identified action plans were developed. For example, for people at risk of choking and malnutrition and for people with moving and handling needs. Risk assessments action plans for moving and handling included photographs to give clear guidance to staff on specific techniques to support people with mobility needs.
The staff team at this service was small and stable. Staff clearly knew people and their families. The registered manager said the staffing levels were to increase to support people with their changing needs. The rota demonstrated additional staff were deployed to assist people to access community facilities. Staff said staffing levels were sufficient to meet people’s needs.
New staff said the induction programme prepared them to work unsupervised. Staff said the training provided developed their skills for them to meet people’s changing needs.
Members of staff enabled people to make choices about their meals, what they wore and the activities they joined. Staff said tasks were explained to the person and they supported people with decision making. Mental Capacity Assessments (MCA) 2005 were completed to assess people’s capacity to make specific decisions. Best interest decisions were made for people where they lacked capacity to make specific decisions.
People were subject to continuous supervision. Deprivation of Liberty Safeguards (DoLS) applications were made to the supervisory body for authorisation. The registered manager said DoLS authorisations were outstanding from the supervisory body.
People were supported with their healthcare needs. People were registered with a GP and health action plans in place supported people with their ongoing healthcare needs. People had access to specialists such as Occupational Therapists (OT), Speech and Language Therapist (SaLT), opticians and dentists.
Care plans on meeting aspects of people’s care needs were developed and described the areas of their care the person was able to manage for themselves. The assistance needed from the staff formed part of the care plan which the staff reviewed six monthly.
An easy read complaints procedure was on display which told people how to raise complaints.
The staff said the team worked well together and there was good team spirit. They said the registered manager was approachable and were given guidance to meet people’s needs.
Systems were in place to gather people's views during house meetings. Quality assurance arrangements in place ensured people's safety and well-being. Systems and processes were used to assess, monitor and improve the quality, safety and welfare of people. There were systems of auditing which ensured people received appropriate care and treatment.