22 June 2017
During a routine inspection
The home provided accommodation and personal care for up to 41 older people, some of whom were living with dementia. There were 33 people living in the home when we inspected. The provider had expanded the communal space in the home, which had reduced the number of bedrooms available. However, the provider had plans to develop the home and increase the number of bedrooms. The accommodation was provided over two floors, a lift was available to take people between floors.
There was a registered manager in post. 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. The registered manager was not available during the inspection, but the deputy manager, the provider’s area manager and the providers were on site to assist with the inspection.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The management team understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.
People’s care was delivered safely and staff understood their responsibilities to protect people who were frail and people living with dementia from potential abuse. Staff had received training about protecting people from abuse. The management team had access to, understood the safeguarding policies of the local authority, and when needed followed the safeguarding processes.
The premises and equipment in the home was clean, odour free and maintained to protect people from infection. Safety systems in the home, like fire alarms were serviced by an engineer and tested to maintain people’s safety. Risks within the home had been assessed and maintenance issues were reported and dealt with in a planned and timely manner. The fire procedure was in date and was regularly practiced by staff.
The management team involved people in planning their care by assessing their needs prior to and after they moved into the service. People were asked if they were happy with the care they received on a regular basis.
When new staff started working at the home, they received an induction and followed a recognised pathway of basic training to gain the skills required to meet people’s needs. We observed that staff knew people well, staff displayed a kind and caring attitude and people had been asked about who they were and about their life experiences.
We observed staff were welcoming and friendly. Staff provided friendly compassionate care and support. Staff were trained and understood the importance of respecting people’s privacy and dignity.
People were encouraged to get involved in how their care was planned and delivered. Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected.
The activities in the home provided people with opportunities to get involved and participate in learning new skills and building new friendships. Community participation was encouraged and supported. People in the home benefited from links to a local Academy School and an art project. We have made a recommendation about this.
There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.
People had access to GPs, community nurses and they accessed opticians, dentists and foot care professionals. People’s health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. We have made a recommendation about this.
Incidents and accidents were recorded and checked by the management team to see what steps could be taken to prevent incidents happening again. The risks in the home were assessed and the steps to be taken to minimise them were understood by staff.
The providers had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. There was an up to date procedure covering the actions to be taken in emergency situations.
Recruitment policies were in place. Safe recruitment practices had been followed. The management employed enough staff to meet people’s assessed needs. Staffing levels were kept under review as people’s needs changed.
Staff understood the challenges people faced and supported people to maintain their health by ensuring people had enough to eat and drink.
If people complained, they were listened to and the registered manager made changes or suggested solutions that people were happy with. The actions taken were fed back to people.
The provider and the management team consistently monitored the quality of the service and made changes to improve the service, taking account of people’s needs and views. The registered manager and deputy manager of the home had provided good leadership to staff. The providers and registered manager implemented plans to improve the service.