20 March 2017
During a routine inspection
At the time of the inspection, there was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Risks to people's health and safety had been assessed but had not been reviewed to ensure all risks had been identified so they could be appropriately managed. There as therefore a risk that people might be receiving safe care and support.
Care plans had also not been reviewed and updated after people’s care were reviewed by care managers to ensure these were up to date and reflected people’s changing needs. These did not also identify clearly the objectives and goals that people wanted to achieve so there were a clear care plan in place about how these objectives and goals were to be met.
The service did not seem to have enough management support as the registered manager could only dedicate part of their time at the service as they also managed two other services and there were only two office staff to help the running of the service. In addition the quality assurance systems at the service were not very effective as they had not identified the concerns we found so the necessary improvements could be made.
People felt safe using the service and were supported by staff who knew how to keep them safe. Appropriate staff recruitment procedures helped to keep people safe by ensuring only the right carers and staff were recruited to work at the service. People received the support they needed to safely manage their medicines.
Carers and staff had the knowledge and skills to care for people effectively and felt well supported by appropriate training and effective supervision.
People were all able to make choices and decisions about their care sometimes with the support of their carers and relatives.
People received support where they needed it to shop and prepare meals and to access appropriate healthcare services.
People told us they found their carers were caring, helpful and friendly towards them. They said they were treated with dignity and carers respected their privacy and wishes.
Carers were able to describe people's likes and dislikes. People told us carers understood them well. People’s cultural needs were met and carers supported people in fulfilling their individual wishes.
People told us they were involved in planning and making decisions about their care. They said carers listened to them.
People were taking part in activities that they enjoyed. For example, people had been supported to go to college and to go on holiday.
People knew how to complain and there was a complaints procedure available to them.
During the inspection we found three breaches of regulations. These were in relation to safe care and treatment, person centred care and good governance. You can see what action we have asked the provider to take at the back of this report.