7 and 8 September 2015
During a routine inspection
The inspection took place on 7 and 8 September 2015 and was unannounced. This meant the provider did not know we would be visiting. The last inspection was carried out on 19 September 2013. The registered provider met all the legal requirements we inspected against.
Carrdale provides accommodation and personal care for up to six adults who have a learning disability.
The registered manager had left their employment in July 2015. There was an interim manager in place, and a new manager was due to start. 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.
People told us they were happy with their care and the care staff. One person said, “I like it here, I want to stay here.” Other comments included: “The girls are lovely, they look after us”; and, “They [staff] are kind to me.” We observed positive relationships between people and staff. One person told us another person using the service was their best friend.
People received their medicines when they needed them from trained staff. Medicines were stored securely and accurate records kept.
Staff had a good understanding of safeguarding and the registered provider’s whistle blowing procedure. They also knew how to report concerns. One staff member said, “I have no concerns regarding safety, people are quite happy.” Another staff member said people were, “Totally safe.”
There had been no safeguarding concerns about people living in the service in the past 12 months.
Risk assessments had been carried out to help protect people from potential harm. These were reviewed regularly so they remained relevant to each person’s needs.
We observed people had their needs met quickly from trained staff. Staff told us staffing levels needed reviewing because the number of people using the service had increased. The interim manager confirmed a review was to be carried out. Recruitment checks were carried out before new staff started caring for people.
People lived in a safe and pleasant environment. One person said, “My room is canny [nice].” One staff member said, “The place is kept clean.” Health and safety checks were carried out to help keep people safe and secure. This included checks on fire safety in the home. There were contingency plans to deal with emergency situations.
Staff told us they were well supported to carry out their caring role. One staff member said they had, “Regular one to ones, we discuss anything.” Staff said management were approachable anytime they needed help. One staff member commented, “Any issues I can go to the manager. [Manager’s name] is very good, if there is anything she can do she will do it.”
People were asked for their permission before receiving care. Where people lacked capacity to make decisions staff followed the requirements of the Mental Capacity Act 2005 (MCA). One staff member said, “If I couldn’t ask [the person] I would do it in their best interests. I would know what their needs were because we have been briefed and read care plans.” Staff used individual strategies to support people with communication difficulties.
People were supported by patient staff to make sure they had enough to eat and drink. One person said, “I am eating well, I get nice meals here.” We observed staff followed people’s care plans to ensure they provided consistent support with eating and drinking. Staff involved people with meal preparation to promote their independence.
People had access to a range of health professionals when needed, such as GPs, occupational therapists, chiropodists, dentists and speech and language therapists.
Staff had access to detailed information about people’s preferences, such as what they liked to eat, family details and a medical history. One staff member said, “I have known people for such a long time.”
People had their needs assessed and this was used to develop personalised care plans. Care plans were up to date and included the information staff needed to provide consistent care. Individual care plans had been developed where people had specific medical conditions. People were involved in identifying goals to work towards.
People were able to take part in activities they had chosen. One person told us they liked dancing. Another person said, “We both like colouring and drawing.”
People had the opportunity to give their views about the service through attending ‘Service user meetings. The meeting had also been used as an opportunity to raise people’s awareness of fire safety in the home.
Staff told us the interim manager was approachable. One staff member said, “If I have any problems I talk it out with the manager. [They are] definitely approachable.”
There were opportunities for staff to give their views about the service, such as team meetings and ‘Vision’ meetings. Due to the change in manager the most recent team meeting minutes available were from a meeting held in April 2015.
We observed there was a positive atmosphere in the home. One person said, “Me and [person’s name] are best friends.” One staff member said, I work well with everybody, we get on.” One staff member said, “People are happy.” Another staff member said, “I like it. Staff get on, they are all professional.”
The registered provider carried out a range of checks as part of a quality assurance programme. These included checks of health and safety, medicines, bedrails and infection control. We found the audits had been successful in identifying issues and ensuring action was taken. The registered provider had a system of peer reviews which gave an external view of the quality of care provided at the home. We saw that no concerns had been identified from the last audit in February 2015.