4 August 2014
During an inspection looking at part of the service
Two adult social care inspectors carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Highstone Mews is a residential care home which was providing care and support to 54 people at the time of our inspection. A number of people living at the home had dementia.
As part of the inspection we spoke with seven people who lived at the home, five members of staff, two relatives, the home manager and two senior managers'.
This was a follow up inspection to check that improvements had been made in the care and welfare of people who use the service and assessing and monitoring the quality of the service.
On our previous inspection on 12 May 2014 we observed one person who used the service being moved and handled by staff inappropriately and not in line with their plan of care. This meant care and treatment was not delivered in a way that was intended to promote people's welfare. Also records seen by us showed that not all of the shortfalls identified in the manager's audits had been addressed.
The manager of Highstone Mews submitted an action plan following our inspection which detailed the actions they intended to take in order to achieve compliance.
Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People were being cared for in an environment that was safe.
The majority of staff had been trained in moving and handling people safely. We observed staff using appropriate equipment in order to move people safely from wheelchairs into comfortable chairs.
One person who used the service told us, 'I have nothing to worry about here.'
We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their lives.
The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people would be safeguarded.
Is the service effective?
Most people we spoke with said they were happy with the care they received and felt their needs were met. One person we spoke with had a number of concerns about their care. The person told us they were happy to discuss their concerns with the new home manager. The person and the home manager agreed to meet with each other on the day of the inspection.
Is the service caring?
At this inspection five people who used the service gave positive feedback about the care and support they received. They told us staff gave them support and assistance when they needed it. People told us, 'The staff here are very nice, always polite,' and 'I've only been here a few weeks but I'm settling in alright' and 'I'm well looked after, the staff are lovely.'
Two people told us, 'When I ask for assistance staff are always saying 'can you hang on a bit' and sometimes I wait for an hour,' and 'They're always short of staff and agency staff don't understand us.'
Two relatives told us, 'We are concerned the home is going downhill. Managers are coming and going and the atmosphere has changed. Some staff are lovely.'
Is the service responsive?
People's needs had been assessed before they moved into the home. Care plans included information about people's preferences, interests and diverse needs.
Is the service well-led?
At this inspection we found there were systems in place for auditing of the service. For example, medication, the environment, infection control, care plans and complaints.
We saw the home manager had carried out regular audits and where appropriate taken action so that the quality of the service was improved.
People who used the service told us they were asked for their feedback on the service they received and that they had filled in a 'customer satisfaction survey'.