7, 13 January 2011
During an inspection in response to concerns
We were told by different people about the improvements they had seen since the new manager and two new qualified learning disability nurses started work at the service in November 2011. One person told us they had previously been concerned about how their relative was cared for, but significant improvements had been made since the new manager started. We were told 'it's much better now, the place has a different feel about it, much better,' and 'I don't worry so much now about what's happening here when I go home.'
As well as recognising the positive work that had been done people also told us about improvements that were still needed. We were told that people who live on the first floor don't have enough space. When we visited we saw that parts of the environment did not fully meet the needs of people living there nor did it support positive person centred work.
We were told there was generally enough staff on duty to meet people's needs during the day time, but also that there were not enough staff in the evenings. People said that the lower number of staff in the evenings limited people's choices and meant there were fewer opportunities to take part in activities. The staff described their plans to provide a better range of activities during the day and in the evening. When we visited we saw that concerns about activities were beginning to be addressed, but that not everyone was benefiting. Because this was seen to be 'work in progress' we have decided to ask the registered provider how they will ensure that all people are supported to become involved in individualised activities.
There have been improvements to the provision of holistic care that considers all the different aspects of people's needs. However, the registered provider still needs to ensure that people's rights to access main stream healthcare are fully supported.
Stronger accounting and financial safeguards were needed to show how the registered provider was protecting people's interests where they had responsibility to manage people's finances. This includes clarity about the decision making process that gives them the authority to act on behalf of a person with impaired capacity.