During the inspection we spoke with two people who used the service and asked them about their experience of living at the home. We carried out a tour of the building and reviewed records relevant to the running of the service. We observed staff interaction with people throughout the home. We spoke with the registered manager, two support workers, a nurse, a domestic assistant and maintenance person. During the inspection we focused on these five key questions; is the service safe, effective, caring, responsive and well-led?
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People were supported and cared for in an environment that was safe, secure and met their needs. The communal areas were clean and tidy and the garden area was well looked after.
Care plans contained detailed information and guidance for staff that enabled them to provide care and support that met people's needs and kept people safe. Records were well maintained and gave detailed information for staff on how to ensure that people were kept safe, whilst encouraging them to maintain as independent a lifestyle as possible.
We saw there were appropriate procedures in place for the safe handling, storage and administration of medicines. Records indicated people received their medication at the correct time by an appropriately trained member of staff. We observed the nurse administer medication to a person who used the service in a way that reflected their wishes within their care plan.
Appropriate checks had been made before staff commenced work at the home. References, criminality and qualification checks had been completed along with on-going registration with professional bodies such as the Nursing and Midwifery Council (NMC).
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted at the time of the inspection, proper policies and procedures were in place. The registered manager could explain the procedure for submitting an application, should one be required.
Is the service effective?
During our previous inspection on 14 August 2014, we identified concerns that had a minor impact on people who used the service. We found that where people did not have the capacity to consent to decisions about their care, the provider did not always follow the correct legal procedure for assessing and reassessing people's capacity in accordance with the Mental Capacity Act 2005. During this inspection we found improvements had been made and where required, mental capacity assessments had been completed.
Staff spoken with had a good knowledge of people's needs. They could explain the care and support each person who used the service required and how they ensured the support was effective. We observed staff interact with people and saw how their calm and patient approach, individualised to each person and their needs, produced a positive outcome for both the person who used the service and the staff member.
Care plan records showed people's needs were regularly assessed. Where appropriate, external professionals had been consulted to offer guidance in areas that required expert input.
Is the service caring?
Staff approached and interacted with people in a calm and caring manner. They used supportive, non-judgemental language when assisting people with behaviour that challenges. We observed staff take calm action when a person became agitated when taking part in an activity of listening to their music. The techniques they used showed they cared about the person they were supporting and genuinely wanted to help them.
A person who used the service told us, 'The staff seem to really care about me, it's great.'
Is the service responsive?
We saw staff responded to people's needs throughout the inspection. We saw the registered manager assist someone with making the right food choices for their lunch. They saw the person was in the process of making a portion of food that appeared excessive. The registered manager directed the person to some guidance, which was made available for people in the kitchen, on how to control portion sizes. The registered manager ensured, that as the person had capacity to make their own decision, they did not instruct the person to change their portion size, but responded to the issue by offering guidance in a calm and reassuring way. As a result of the registered manager's guidance the person decided to reduce the size of the portion of their lunch.
We looked at records which confirmed that people's interests, beliefs and needs had been recorded and identified and staff responded positively to these.
Is the service well-led?
The registered manager had effective processes in place to regularly monitor the quality of the service provided and whether people's needs were being appropriately met. We saw regular audits took place to monitor the quality of care plans, the environment and the administering of medication.
People's views were welcomed and acted on. Staff spoken with told us they felt able to raise any issues they had with the registered manager. They told us they felt supported and their views were respected. A care worker we spoke with told us, 'The manager is brilliant, the manager has done our job before so she has experienced what we do. She knows how to relate to us.'