10 April 2014
During a routine inspection
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found:
Is the service safe?
We found the service to be safe because they had a range of policies and procedures in place to protect the people who lived in the home.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.
The care and support plans we looked at contained clear information about identified risks and how risks should be managed. Examples included supporting people to access the community and the management of people's finances. We saw that a plan of care had been developed to manage any identified risks in the least restrictive way. This meant that people could be supported with activities with reduced risks to themselves or to the people who supported them.
Staff were able to provide safe, appropriate and personalised care to the people who lived at the home. Each person had a plan which described the care and support they required and how staff should provide it. These plans also included who the important people in their life were, how people communicated, daily routines, preferences and how they made decisions. We spoke with three members of staff, one of which had been recently employed. They told us the care plans told them everything they needed to know about the people they supported.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to safely manage medicines.
There were sufficient numbers of suitably qualified, skilled and experienced staff on duty to meet the needs of the people who lived at the home.
Is the service effective?
We found the service to be effective because people's care treatment and support achieved good outcomes. We also found that people's rights and choices were respected by staff.
People were enabled to make, or participate in making decisions relating to their care and treatment. The people who were able to communicate with us told us they were supported to make choices and decisions about all aspects of their lives. Comments included 'I decide what I want to do and the staff support me' and 'the staff support me well. They know what helps me to stay calm.'
People were treated with respect and their right to privacy was upheld.
Is the service caring?
People told us they felt safe and well cared for and all commented on the kindness of the staff. Throughout our visit we observed staff interactions with people to be kind and respectful and people appeared very comfortable in the presence of staff.
We observed staff were very skilled in recognising and responding to changes in people's behaviour. The staff we spoke with had a very good understanding about the needs and preferences of the people they supported. They understood and responded to people's needs and requests where individuals were unable to make their wishes known verbally. This demonstrated that staff knew people well.
Is the service responsive?
The service was responsive to people's needs. Staff had up to date guidance on how to support each individual. We read the care plans of three people who lived at the home. These contained assessments of need and outlined how needs would be met. The assessments were regularly reviewed to ensure they reflected people's up to date needs and preferences.
People's health care needs were monitored and responded to appropriately. Information about people's health needs and contact with health and social care professionals had been recorded. We were informed that the service received good support from health and social care professionals and there were no problems obtaining their input for people when required.
Is the service well led?
The service was well led because there were systems in place which monitored the quality of the service provided. The service was proactive in seeking the views of the people who lived at the home and their representatives. We saw that the service responded to any comments or suggestions made.
The service was managed by a person who had been registered by the Commission. The registered manager regularly provided 'hands-on' care. This meant they remained up to date with the needs and preferences of the people who lived at the home. The staff we spoke with told us they received the training and support they needed. They told us the manager responded to training requests and that they found them "very approachable."
We found procedures were in place to minimise any risks to the people who lived at the home. Regular internal audits had been carried out which monitored the on-going health and safety of people. Internal audits included checks on the home's fire systems, environment, care planning and the management of people's medicines.
People using the service were provided with opportunities to express a view on the quality of the service they received. Quality assurance procedures helped to reduce risks to people who lived at the home.