As part of this inspection we carried out an unannounced visit to the home. We observed routines throughout the day and interaction between staff and residents. The home was busy with various activities going on. A visiting musician was entertaining some residents whilst others had a walk to the park. Residents were seen moving around the home freely, some choosing to sit out in the sun. There were a variety of visitors throughout the day.
We noted that staff supported people in a kind, respectful manner. Staff were seen to attend to residents' requests promptly and in a pleasant way. The interaction between the staff and residents was very positive with lots of friendly discussion and joking.
We spoke with residents and in some cases, their relatives. In general, the feedback we received was very positive and most people expressed satisfaction with their care and spoke highly of staff.
One person commented, 'This is a place where the staff and managers really do care about the residents. I think the standard of care is brilliant.' A resident told us about the recent refurbishment that had taken place. He said he had felt involved throughout. 'It was marvellous. They came to me and asked me where I wanted my shelves and plug sockets. It was all done to my request!'
Other comments included:
'I have always been very happy here. The care is very good.'
'We have been more than satisfied with the whole package! No complaints whatsoever.'
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, staff and from looking at records.
We asked five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Is the service safe?
Staff knew what care people needed to keep safe and understood the risks to individual resident's safety and wellbeing. Staff knew what measures they needed to take to protect people from harm.
Where people's rights were restricted in their best interests, the manager had gained the appropriate authorisation and worked in accordance with the Mental Capacity Act and Deprivation of Liberty Safeguards.
Staff had clear guidance about supporting people with complex behavioural needs and had received training in areas such as de-escalation and physical intervention.
Staff were aware of their duty to report any suspected abuse or poor practice and felt confident to do so. Staff had received training in recognising abuse.
Staffing levels were adequate to safely meet the needs of people who used the service. People received their care from a consistent staff team who they were familiar with.
Staff were trained in important health and safety areas such as fire safety, infection control and moving and handling.
The manager and staff learned from events such as accidents, complaints and safeguarding investigations. However, records did not always reflect this. Records of audits, and the monitoring and analysis of adverse incidents would help ensure risks to people were quickly recognised and addressed. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to record keeping.
Is the service effective?
People we spoke with expressed satisfaction with their care and felt their needs were well met.
Residents appeared content in their surroundings and got along well with staff.
We saw some residents had experienced good outcomes due to the care they had received. For example, improvement in mental and physical health since their admission to the home.
People were supported to access support from community professionals such as District Nurses and GPs. The home had systems in place to ensure that any advice given by external professionals was incorporated in people's care plans.
There were ample numbers of staff on duty to provide effective care and respond to people's individual requests.
Staff had training in a number of areas to help them provide safe and effective care.
People's care plans and risk assessment information did not always reflect all of their needs or was not fully up to date. This meant that people could be at risk of not receiving the right care. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to record keeping.
Is the service caring?
People we talked with spoke very highly of staff describing them in ways such as 'kind', 'caring' and 'helpful.'
We observed people receiving support and saw that this was provided in a pleasant and respectful manner. Staff addressed residents with kindness and patience. Staff responded to resident's requests straight away and appeared happy to do so.
People's privacy and dignity was respected and promoted by the manner in which staff supported them.
The manager had introduced a new care planning tool called 'This is me.' This helped carers to understand the things that really mattered to people and made a difference to their daily lives. For example, their preferred daily routines, hobbies and important relationships.
Is the service responsive?
We saw that feedback from residents and their families was encouraged. The manager was able to give us examples of changes that had been made as a result of people's feedback.
People that we spoke with told us they were able to raise concerns and felt that the manager was approachable. One person we talked with had recently had cause to raise a concern, which she felt had been responded to appropriately.
We saw examples of improvements made within the service as a result of feedback from other professionals. For example, the home had implemented a detailed improvement plan as a result of a recent local authority quality inspection.
There was evidence that changes in people's care needs were identified by staff and responded to appropriately. For example, we looked at the care plan of one person whose general health had deteriorated. We saw that staff had been quick to seek medical advice and adapt the resident's care plan in line with their new needs.
We were able to confirm that staffing levels were developed in line with the needs of residents. There were processes in place to ensure that additional staff could be brought onto duty if any residents required additional care.
The manager and staff learned from events such as accidents, complaints and safeguarding investigations. However, records did not always reflect this. Records of audits, and the monitoring and analysis of adverse incidents would help ensure people received an effective service. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to record keeping.
Is the service well led?
People told us the manager and provider were approachable and supportive.
The manager maintained a strong and regular presence in the home and was constantly available to residents, relatives and staff.
The manager listened to feedback from people who used the service and other professionals and took action in response to it.
Staff had good understanding of their roles and duties. Staff understood how to raise concerns and felt confident in their manager to deal with concerns appropriately.
There was a quality assurance system in place, which included the use of audits and the monitoring of adverse incidents and complaints. However, these were not always well recorded. Records of audits, and the monitoring and analysis of adverse incidents would help ensure any shortfalls in the quality of the service were quickly recognised and addressed. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to record keeping.