4 September 2014
During a routine inspection
As part of this inspection we spoke with five people who use the service, three relatives, the registered manager, three members of staff and one professional who worked with the service. We reviewed records relating to the management of the home which included, six care plans, five staff personnel files, daily care records, risk assessments, audits, policies and procedures. We also spoke to the local authority Commissioners.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
Is the service safe?
Care plans gave guidance and instruction to staff on how to meet people's needs in a way which minimised risk for the individual. They ensured that staff had the information necessary to support people safely.
People's records showed they had access to routine and specialist health services. Directions from professionals were recorded accurately in the care plan and staff we spoke with knew how to access and follow them.
Records we looked at were accurate and fit for purpose. We saw they were stored securely and could not be accessed by unauthorised people. Staff personnel files contained appropriate pre-employment checks.
Medicines were managed appropriately. There were systems in place to order, store, record and dispose of medicines in a safe manner. People told us they were supported to take their medicines as they wished.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). We spoke with the manager with regard to the Supreme Court ruling which widened and clarified the definition of deprivation of liberty. They were aware of the ruling and had been in contact with the local authority DoLS team. At the time of the inspection two applications were being prepared.
Is the service effective?
People were supported to use a range of health care professionals including speech and language therapists, psychologists, audiologists and GPs.
Staff were observed supporting people in a friendly and patient manner and people appeared relaxed and happy in their homes.
Activities were planned individually and we saw how staff had worked with people who have limited verbal communication skills using photographs of activities and people participating in them.
Is the service caring?
Relatives we spoke with commented positively on the support their loved ones received. For example, one relative said: 'I'm thrilled with the care' receives.' We observed staff being polite and treating people with respect. People told us staff helped and supported them, for example: 'I get on with all the staff; they help me do what I need to do.
Is the service responsive?
People's needs had been assessed before they started using the service. People's needs were reviewed with them and their relatives as appropriate. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to meaningful activities and they had been supported to maintain relationships with their friends and relatives.
We spoke with relatives of people who use the service. They told us they could talk to staff if they were unhappy about something. They said they felt confident they would be listened to and action would be taken if necessary.
One professional we spoke with said: 'staff and managers always appear responsive and keen to provide the best service they can.'
Is the service well-led?
Quality assurance processes were in place. Staff told us they felt they could approach the senior staff for advice. They knew and understood their responsibilities and the importance of their role. Regular meetings were held to ensure all staff were up to date with changes to people's care and the expectations of the service. People and their relatives said they were consulted about their views and they had completed satisfaction questionnaires.