Background to this inspection
Updated
4 February 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 17 December 2015 and was unannounced. The inspection team comprised of three inspectors, a specialist adviser and an expert by experience. A specialist advisor is someone who has current and up to date practice in a specific area. The specialist advisor who supported us had experience and knowledge in nursing care for people with dementia. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed the information we held about the service. We looked at information received from relatives and visitors; we spoke to the local authority commissioning team who made us aware they had visited in July 2015. Some concerns had been raised with us by staff about staffing levels. We reviewed the statutory notifications the registered manager had sent us. A statutory notification is information about an important event which the provider is required to send us by law. These may be any changes which relate to the service and can include safeguarding referrals, notifications of deaths and serious injuries.
We asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We received this information prior to our visit and this reflected the service we saw including plans for improvement.
We spoke with 12 people who lived at the service, five relatives, two friends and three professionals. We spoke with 23 staff including the registered manager, nurses, care staff, the activities co-ordinator and the cook. We looked at 12 care records, and records of the checks the registered manager made for assurance that the service was good. We observed the way staff worked and how people at the service were supported.
Some people living at the home had a diagnosis of dementia and were unable to share their experiences of the care and support provided. We therefore spent time observing care in the lounge and communal areas. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us.
Updated
4 February 2016
We carried out this inspection on 17 December 2015. The inspection was unannounced. .
The service is registered for up to 109 people and offers accommodation for people who require nursing or personal care. At the time of our inspection there were 77 people living at the service including one person staying there temporarily receiving respite care. The service consists of three areas, Assisted Living, Reminiscence (for people living with dementia) and the Cotswold Suite (for people with higher levels of independence).
A requirement of the service’s registration is that they have 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A registered manager was in post and had been since November 2014.
There was not always enough staff available to support people at times they preferred. Staff were not always able to support people quickly or respond to their needs effectively.
People told us they felt safe living at the service. Staff knew how to safeguard people and what to do if they suspected abuse. People were protected from harm as medicines were stored securely and systems ensured people received their medicines as prescribed. Checks were carried out prior to staff starting work at the service to make sure they were of good character and ensure their suitability for employment.
People’s health and social care needs were reviewed regularly. Staff referred to other health professionals when needed, so people were supported to maintain their health and wellbeing. Risk assessments were completed and plans minimised risks associated with people’s care.
Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLs). Staff ensured they gained consent from people before supporting them with care.
Staff had training to do their jobs effectively in order to meet people’s care and support needs. Overall staff told us they felt supported by the management team to carry out their roles effectively.
People’s nutritional needs were met and special dietary needs were catered for. People took part in some organised activities and trips, and told us there was plenty for them to do.
People told us they liked living at the service and that staff were kind and caring. People were cared for as individuals with their preferences and choices supported. Staff treated people with dignity and respect when supporting them and encouraged people to be independent. Relatives were encouraged to be involved in supporting their family members.
People were positive about the management team and the running of the service. Staff felt that recent management changes were positive in improving the service further.
The registered manager was responsive to people’s feedback in developing the service, and making continued improvements such as recruiting more staff. Systems and checks made sure the environment was safe. People knew how to complain if they wished to, and these were recorded and responded to by the management team.