Our inspection team was made up of an inspector who answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
During our visit we saw that people were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were robust, staff understood how to safeguard the people they supported and had received training. Details of specific areas or circumstances under which people may be particularly vulnerable were written down in the care plans we saw.
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helps the service to continually improve.
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards, although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.
The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.
The staff rotas took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met.
No staff had been subject to disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.
Is the service effective?
There was an advocacy service available if people needed it, this meant that when required people could access additional support.
People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. One person said that they had been involved in writing their care plan and it met their current needs. The care plans had been signed by people using the service. People told us "I'm going to the park", "I'm going to have my lunch now" and "I've been to work today".
The layout of the service enabled people to move around freely and safely and the premises met the needs of people with physical impairments.
Visitors confirmed that they were able to see people in private and that visiting times were flexible.
Is the service caring?
People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. People commented, 'The staff are my friends'. A relative said, 'In the main very good and friendly, the atmosphere is happy and I am confident in the staff although they can be under pressure sometimes'.
People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed. The home is also part of the Richmond Council 'Quality assessment framework'.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People completed a range of activities in and outside the service regularly. During our visit people were coming from and going to a number of different activities either individually or as a group. The home has access to transport, which helps to keep people involved with their local community.
People knew how to make a complaint if they were unhappy. Two people said that they had never needed to make a complaint as any problems were generally sorted out on the spot or during house meetings . We looked at how complaints were investigated. People could therefore be assured that complaints were investigated and action was taken as necessary.
Is the service well-led?
There was a new management structure in place that was pro-active, listened to people's needs and opinions and acted upon them. They were introducing a number of new initiatives and had employed consultants to introduce practice improvements in areas they felt required it. The service worked well with other agencies and services to make sure people received their care in a joined up way and was part of the Richmond Council 'Quality assessment framework'.
The registered manager was away from work and suitable covering interim measures were in place. Appropriate notifications to the Care Quality Commission had been made.