27 January 2016
During a routine inspection
This inspection took place on 27 and 28 January 2016 and was unannounced.
The service had 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. At the time of our inspection, the deputy manager who had stood down from the lead role still held the registered status as the new manager’s application had not yet been accepted by the Care Quality Commission.
The people living in the home told us that they felt safe with the support from the care staff. Relatives we spoke with confirmed this. Policies and procedures were in place to protect people from harm and to ensure staff understood all of their responsibilities.
Accidents and incidents were investigated promptly and where appropriate the manager had informed the local authority and the Care Quality Commission. Records were analysed by the manager and used to review people’s care needs, risk assessments and implement control or preventative measures.
Risks associated with the health, safety and wellbeing of the people who lived in the home were managed well, including carrying out checks of the premises and equipment in line with their legal responsibilities. People’s care needs had been assessed and we saw evidence in records which demonstrated this was monitored and reviewed regularly.
The service safely managed people’s medicine and medicine administration records were detailed and accurate. Medicine was stored safely and securely. The staff followed policy and procedures with regards to receiving, storing and disposing of medicine. All other records which related to the management of the service were well maintained.
Staff told us there was enough staff employed by the service to operate it safely and to meet people’s needs. Staff files showed the recruitment process was safe and staff had been appropriately vetted. Training was up to date, and the staff had a range of skills and experience. The manager gave staff the opportunity to gain qualifications in care by liaising with an external provider.
Supervision and appraisals were held regularly and documented by the manager or a senior nurse. Staff and relatives’ meetings were also held and notes were taken. This demonstrated that stakeholders had an opportunity to speak to the manager regularly. Task based competency checks were undertaken by senior staff to assess staff’s suitability for their role.
Evidence showed the manager and staff had an understanding of the Mental Capacity Act (MCA) and their own responsibilities. The senior staff had assessed people’s mental capacity and reviewed it. Care records showed that wherever possible people had been involved in making some decisions, but significant decisions regarding people’s care were made in people’s best interests and had been appropriately taken with other professionals and relatives involved.
People were encouraged to maintain a balanced diet. We observed people in the dining room at lunchtime; staff endeavoured to make this a positive and interactive experience. People had some choice around their meal and often chose from the planned menu, some people and their relatives told us they could choose something else, which the cook was happy to prepare.
People’s general healthcare needs were met by staff involving external healthcare professionals whenever necessary. For example, we reviewed care needs records containing input from district nurses, the tissue viability team and speech and language therapists. Staff told us they worked closely with healthcare professionals and followed their instructions and advice to assist them to care and support people appropriately.
Staff displayed kind, caring and compassionate attitudes and people told us the staff were friendly and nice. We observed people’s privacy being upheld and they were treated with dignity and respect.
A newly appointed activities coordinator was employed to enhance people’s socialisation skills. People engaged with activities on a one to one basis and also in groups. A new programme of activities was being developed which included trips out and bringing local community services into the home.
The manager kept a record for complaints and told us how the complaints procedure was managed. During the inspection people and their relatives told us they had nothing to really complain about but would tell staff or the manager if something was wrong.
Quality monitoring took place regularly which involved people, relatives and staff being asked for their feedback via meetings and surveys. The manager undertook audits to ensure the quality and safety of the service. The provider oversaw this and also audited the records. Action plans were drafted to improve the service following audits and surveys.
The staff team were consistent. Staff told us they felt valued and they enjoyed their job. The manager and provider promoted staff recognition schemes which staff told us boosted their morale.