8 August 2017
During a routine inspection
The home had a registered manager. 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 the last inspection in May 2015 the service was rated good in all the domains and overall. At this inspection we found that the service continued to be good.
Staff had a clear understanding of how to assess, monitor and manage risks to keep people safe. There were enough suitable staff on duty to care for people safely. Medicines were stored and administered safely and staff understood their responsibilities with regard to safeguarding people. Relatives told us that they were confident that their relations were safe at the home. One relative said, “I visit regularly and there are always enough staff on duty.” Another relative told us, “They provide brilliant care, it is absolutely safe.”
The provider had robust recruitment systems in place and staff were supported in their roles. They received the training they needed to look after people and support their needs. One staff member said, “The training we get is very useful and relevant to the role.” Relatives told us they had confidence in the skills and knowledge of the staff. One relative said, “They are very well trained, if not they couldn’t do the job.”
Staff understood their responsibilities with regard to the Mental Capacity Act 2005 and people’s capacity to make decisions had been considered. There was clear documentation to show how decisions had been made in people’s best interests, in line with the legislation. Staff continued to seek consent from people about everyday decisions and offered them choices and options. People were supported to access the health care services they needed. When people had needed to be admitted to hospital staff members had stayed with them to support them to communicate. One staff member said, “We make sure that staff can stay with them because they are so vulnerable without people who know them well.”
People were supported to have the food and drink they needed. Risks associated with eating and drinking had been identified and assessed. Where Speech and Language Therapists had made recommendations about how to support people safely these had been incorporated into people’s care plans to guide staff. Staff monitored people’s weight and had a good understanding of people’s preferences and dislikes regarding their food and drink.
Staff had developed positive relationships with people. We observed how people were comfortable with staff and showed affection towards them. Staff spoke with warmth and admiration about the people they were caring for. One staff member said, “They have so much adversity to cope with yet they are cheerful happy people.” Relatives spoke highly of the care, one relative said, “The staff are so kind, I don’t think (person’s name) has ever been happier.” People were treated with respect and their dignity was maintained. Staff supported people to be involved in making decisions about their care and support and respected their choices.
People were leading full and busy lives. Staff supported them to access the local community and to
maintain their interests. One staff member said, “We need to help people to have the best quality of life that they can possibly have.” People were supported to maintain relationships that were important to them. Some relatives told us that staff supported people to visit them and described how this helped them to remain in contact with their family.
The provider had a complaints system in place and relatives said they would feel comfortable to raise any concerns or complaints with staff. The registered manager told us they welcomed complaints saying, “It’s important feedback, and helps us to make improvements.”
Relatives and staff described the registered manager as being approachable and easy to talk to. They spoke highly of the leadership and management of the home. One relative said, “It is very well managed, the best manger we have known and the deputy is very good as well.” Staff told us they were able to raise any issues openly and felt that their views were welcomed and listened to. One staff member said, “The managers are fantastic here, the staff are happy and we all know what we have to do. Any problems we can discuss straight away. It’s the best home I have worked in.”
There were effective management systems in place to monitor quality within the home. Record keeping was robust and regular audits were undertaken to ensure good governance within the home. The registered manager used a service development plan to drive improvements and this was updated on an annual basis. Staff had a clear understanding of the vision and values of the service and this was embedded within their practice.