During our previous inspection on 6 November 2013 we found shortfalls with the safety and suitability of premises. The provider submitted an action plan 30 December 2013 telling us how they would address these shortfalls. As part of our inspection on 1 May 2014 we followed up on the non-compliance found at the last inspection. We found that improvements had been made to address our concerns.
During this inspection we spoke with seven of the twenty two people currently living in the service and two visitors to the service. We also spoke with four members of staff including the registered manager.
We looked at four people’s care records and three staff files. Other records seen included: care plans and risk assessment reviews, complaints log, resident meeting minutes, staff meeting minutes, relatives meeting minutes, accidents and incidents log, medication audits, staff rota, fire safety checks, maintenance logs, water temperatures, and safety checks on equipment.
We considered the evidence we had gathered under the outcomes we inspected. We used the information to answer the five 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?
When we arrived at the service a member of staff asked to see our identification and asked us to sign in the visitor’s book. This meant that appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access the service.
People told us they felt safe, protected and their needs were met.
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, we saw that policies and procedures were in place. The registered manager confirmed that 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.
Records seen confirmed that staff were booked onto upcoming or had received training in safeguarding vulnerable adults from abuse, the Mental Capacity Act (MCA) 2005 and DoLS. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.
There were effective policies and procedures for managing risk. Staff understood and consistently followed them to protect people.
Records seen confirmed health and safety was checked in the service and equipment was maintained and serviced.
Is the service effective?
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.
Records showed that staffing levels were based on the level of dependency and needs of the people who used the service.
Support for staff was provided through effective training, supervision and appraisal.
People especially those with complex needs, were protected from the risk of poor nutrition, dehydration, swallowing problems and other medical conditions that impact on their intake.
Is the service caring?
Care was individualised and centred on each person.
Staff had a good understanding of the people’s care and support needs and knew them well.
Staff interacted with people who used the service in a caring, respectful and professional manner. People told us they were happy with the care they received and their needs were met. One person told us, “The staff are kind, caring and compassionate, it’s very good here”.
People who used the service, their relatives and other professionals involved with Quenby Rest Home completed satisfaction questionnaires. Where shortfalls or concerns were raised these were addressed.
Is the service responsive?
People's choices were taken in to account and listened to.
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 a doctor, district nurses, community matron and chiropodists.
People told us they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate actions had been taken to address them.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way.
Staff told us they were clear about their roles and responsibilities and were supported and trained to meet people’s needs.
People's care records and risk assessments were accurate and up to date.
The provider had systems and procedures in place to monitor and assess the quality of the service provided. There were records to identify shortfalls in the service and how they had been addressed.
Feedback from people who used the service about their experiences was valued, taken into account and influenced the running of the service.