During our inspection we spoke with 23 people who used the service and 17 visiting relatives and friends. We spoke with the manager, deputy manager, clinical, training and lead managers and 13 staff members.
Admirals Reach provided a service for people with nursing, personal care, rehabilitation and dementia related needs in five separate houses. We looked at the care records for 13 people who used the service. We also looked at how people consented to their care, the safeguarding of vulnerable adults from abuse records, medication, infection control and quality assurance checks.
We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is a summary of what we found;
Is the service safe?
Staff we spoke with told us that they were aware of the action they would take if they suspected abuse was or had taken place. This assured people who used the service that staff had the knowledge to know how to respond and keep them safe. One family member said, 'I feel [my relative] is very safe here."
We found that the service had suitable arrangements in place to gain people's consent and assess their mental capacity to make decisions before acting on their behalf. Mental Capacity Act (MCA) 2005 assessments and Deprivation of Liberty Safeguards (DoLS) were in place and applications had been made on people's behalf.
The policy, procedures and quality monitoring of the service included health and safety and reviews of care planning and delivery. People were provided with care and support that ensured their welfare and safety.
Is the service effective?
People's assessments showed that their care, support and treatment was planned and delivered in a way that ensured that their needs were being met. However, improvements were needed in the way records about people were written. The staff were knowledgeable about people's needs and personalities, their likes and dislikes. A family told us, 'Our [relative] has been in two homes before coming to Admirals Reach but had not settled in either. They had settled down very quickly at Admirals Reach and we are so happy that we brought them here. They seem very content.'
Individualised care meant that people and their relatives were involved, where possible, in choices and decisions about their lives. This made their care more effective as it enhanced their wellbeing, independence and self-worth.
One relative said, 'I wouldn't change anything about this home. They treat my [relative] so well, and look after me too. As soon as I arrive, they'll make me a coffee, and always make me feel very welcome. I can come and go as I please."
Is the service caring?
We saw good interaction between staff and people who used the service. Staff were appropriate in the way they approached and provided care for people. Staff spoke to people respectfully; they were considerate, courteous and patient. Everyone we spoke with told us that the staff were kind and friendly. One person told us, 'They [a staff member] are wonderful, when I'm upset they will sit with me, cuddle me and show me they understand ' I can't help it, I don't know what I'd do without them.'
People's preferences and diverse needs had been recorded in their care files and care and support had been provided in accordance with their wishes. This showed that people were cared for by staff who were respectful and caring. One person said, 'The staff are all lovely, to them it's a vocation not just a job.' Another said, 'The staff are very kind to all the residents.'
Is the service responsive?
Regular checks on the levels of nursing and personal care people needed were undertaken. There were sufficient staff on duty to respond to people's needs appropriately.
The service responded to people's needs in an appropriate way. Systems were in place to ensure that people were satisfied with the service they received. One family member said, 'Before my [relative] came here they used to shower a lot, then suddenly they were only allowed to have one bath once a week and they hated it. We made a bit of a fuss and were listened to and my [relative] now has a shower on another day as well.'
We saw from the records viewed that the service worked well with other agencies. A range of health and social professionals from the community were involved in people's care. This showed that people received their care in a joined up and holistic way.
Is the service well-led?
A comprehensive quality assurance process and action plan was in place which was monitored regularly to review progress and deliver on improvements.
Regular reviews of people's nursing and personal care needs, checks on staffing levels and the management of a skilled and experienced staff team showed that people received a good service.
The service was well-led as it was continually improving in its care provision for people who used the service.