We spoke with eight people who used the service. We also spoke with three staff members. We looked at five people's care records. We looked at other records including health and safety checks, staff and resident meeting minutes and the result of the satisfaction survey that had been carried out by the service. During our inspection and the analysis of our inspection findings we considered the 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?
We found that the service was safe. When we arrived our identification was checked and we were asked to sign the visitor's book. Later, when we needed to re-enter the building, a different staff member challenged us for our identification. This showed that the staff took the security of the building and the safety of the people who lived there seriously.
We saw that staff wore their identity badges so that visitors and non-authorised people could be identified.
When we spoke with people they told us they felt safe living in the service and that they would speak with the staff if they had concerns.
Staff were trained to identify and act on any suspicion of abuse and our records showed that the service had acted quickly to safeguard people if they considered people were at risk.
We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), which was updated every year. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.
We saw records which showed that the health and safety checks were carried out in the service regularly and action was taken if equipment was found to be faulty or unsafe. This included regular visual checks and servicing of equipment such as hoists, the fire alarm panel and wheelchairs. Regular fire safety and legionella tests and checks were carried out, which showed that people were protected from unsafe or poorly maintained equipment.
We saw that there were sufficient staff on duty to protect people’s health, safety and wellbeing. The staff rota and dependency level assessments showed that the service assessed people's needs to ensure that there were sufficient numbers of staff to meet their needs. People told us that the staff were available when they needed them. One person said, "I don’t have to wait long for help." Another person told us that, “We are always properly looked after.”
Is the service effective?
People told us that they felt that they were provided with a service that met their needs. One person said, "It’s brilliant here, especially when the sun comes out and we can get into the garden."
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.
Is the service caring?
We saw that the staff interacted with people who lived in the service in a caring, respectful and professional manner. People told us that the staff treated them with respect. One person said that staff were, "Alright." Another person told us, "I couldn’t find anything to complain about."
Is the service responsive?
People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to. The activity team worked flexibly, coming in at different times of the day to enable people to participate in activities of their choice.
We saw evidence that the service was flexible and made changes as required to ensure people were kept safe. For example staffing levels were based on the assessed needs of the people. If necessary, because of unforeseen circumstances, staffing levels would be increased to ensure people’s needs were met.
People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including the doctor, district nurse and dietician.
The people who used the service, their relatives and other professionals involved with Handford House who had completed the satisfaction questionnaires said that they felt that the service responded well to concerns raised with them. Where shortfalls or concerns were raised they were dealt with quickly.
Is the service well led?
Annual surveys were sent to the people who used the service and their relatives. The questions included; how do you rate the standard of care delivery in the home and how do you rate the standard of how telephones enquiries are handled? Forty-five questionnaires were returned and 87% of the questions were answered positively. Of those sent to the professional bodies, 12 were returned and 96% of them were positive.
The service had an effective quality assurance system in place and the records we examined showed that identified shortfalls were addressed promptly. This would ensure that the quality of the service was maintained.
The staff we spoke with told us that the manager was supportive, easy to approach and listened to what they had to say. The manager also told us that they felt supported by the organisation and by their direct line manager, who visited the service regularly to offer support and to check compliance.