At the time of our visit there were 20 people living at this location; it is registered for 20. The manager told us that 14 people were permanent residents, five people were on respite or short breaks and one person had been admitted for assessment purposes. We spoke with three people using the service, one relative and with five staff.There is a day centre linked to the care home, but this is not regulated by CQC. We were told that some people who used the service were also able to access activities in the centre and were supported to do this. We did not visit the day centre.
Our inspection was undertaken by one inspector. We considered our inspection findings to answer questions we always ask: 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, their relatives, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary, please read the full report.
Is the service safe?
People had risk assessments in place and these were reviewed regularly. We saw that risks were rated from a '4' which meant a serious or imminent risk, down to '0' which indicated no apparent risk. This meant that staff had a clear idea of people's risks and could support them accordingly.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We were told that no applications have needed to be submitted. However, the manager told us that they would be re-assessing and reviewing all people who used the service in the near future. This meant that people would be safeguarded as required. Relevant staff had been trained to understand when an application should be made and how to submit one.
Medicines were kept safely and securely. We saw that appropriate arrangements were in place in relation to the recording of medicine. We looked at the medication administration record (MAR) charts for people and these had been completed appropriately. Senior care staff had received training in medication and we saw that this had been updated in January 2014.
Is the service effective?
People who used the service had varying needs and levels of capacity. One person confirmed that they could always make their own decisions and said, 'Yes, I can make my mind up'. Staff we spoke with confirmed that they would always ask people's permission before carrying out their care needs.
Care records we looked at had been reviewed and updated on a monthly basis. Any changes that had been identified were documented in the care plan. Routine updates to the plans meant that people's most up to date needs were met.
Care staff described the training they had received in areas such as safeguarding adults at risk, manual handling and dementia awareness. We saw details of mandatory training that had been completed by care staff and that there were also opportunities for care staff to study for additional qualifications. This meant that staff were appropriately qualified to deliver care to an appropriate standard.
Is the service caring?
On the day of our visit, we observed some people were supported to eat their lunch by care staff. One person was unable to put food on their fork and the care staff gently pushed a mouth sized portion of food onto their fork. The person was then able to lift the fork and feed themselves; this action encouraged them to maintain their independence. One person told us that, 'People are wonderful ' kindness itself'.
One person told us that they enjoyed laying the table and clearing away plates and that staff encouraged them to do this. They said, 'Lovely. Home from home'. We observed that care staff interacted with people in a warm and sensitive manner. For example, one person could not decide whether they had finished their lunch or not. We saw their plate of food was left for them a little longer, rather than being cleared away.
Is the service responsive?
We looked at records that related to accidents and incidents or 'near misses'. One record described how a person had tried to climb out of a window and that they were more anxious in the afternoon. We saw that the risk assessment had been updated following this incident. This meant that learning had occurred and that appropriate preventative measures had been put in place to reduce the risk of reoccurrence.
A dessert on offer at lunchtime did not appear to be liked by many people who were in the dining area. We saw that staff offered one person the choice of additional sugar to make the food more palatable. Other people were offered another choice of dessert, rather than having to go without.
Is the service well led?
The provider had made arrangements for people to have access to a member of staff who was trained in a listening capacity. People could meet with them on a 1:1 basis and talk about any issues or matters of concern. This worked well as people had the time and space to vocalise their thoughts.
There were also opportunities for carers and relatives to meet up on a regular basis and speakers were brought in to present on a variety of topics.
Staff told us, '[It's} quite easy going here. If you had a concern or issue, they're open to discussions. They listen to what you have to say'.