The inspection took place on 09 and 10 March 2015. The inspection was unannounced.
The home provides care for up to 46 older people, and includes a dementia care unit for 24 people located on the first floor. On the day of our inspection there were 41 people using the service.
The home had a registered manager. 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.
We spoke with care staff who told us they felt supported and that the registered manager was always available and approachable. Throughout the day we saw that people and staff were very comfortable and relaxed with the registered manager and staff on duty. The atmosphere was calm and relaxed and we saw staff interacted with people in a very friendly and respectful manner.
Care records contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary. We saw records were kept where people were assisted to attend appointments with various health and social care professionals to ensure they received care, treatment and support for their specific conditions.
We found people’s care plans were written in a way to describe their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format wasn’t easy for service users or their representatives to understand; they lacked plain English and were long and complex. However, we were informed by the registered manager that a new care plan format was being piloted. We viewed these and saw immediately that they were much more user friendly. We did see evidence to demonstrate that people or their representatives were involved in their care planning.
The staff that we spoke with understood the procedures they needed to follow to ensure that people were kept safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.
Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff were responsive to people’s needs and wishes.
When we looked at the staff training records they showed us staff were supported to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended face to face and e-learning training to maintain their skills. They told us they had regular supervisions with a senior member of staff where they had the opportunity to discuss their care practice and identify further training needs. We also viewed records that showed us there were appropriate recruitment processes in place.
The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).
During the inspection we saw staff were attentive and caring when supporting people. When we spoke with people who used the service and their relatives. We were told they were extremely happy with the care, treatment and support the home provided. Other professionals we spoke to were very positive about the care provided
We observed people were encouraged to participate in activities that were meaningful to them. For example, we saw staff spending time engaging people with dementia on a one to one basis, and others were involved in arts, crafts and baking. Others and some relatives were using the shop and cafe that had just opened on the dementia care unit.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a selection of choices. For some people who had communication needs, we saw pictorial menus were used to help them to choose what they wanted to eat. For those people that required assistance to eat their meal, this was carried out in a dignified and discreet manner.
We found the building met the needs of the people who used the service. For example, the environment was suitable for people who used a walking aid and wheelchair users. We saw the dementia care unit had been specifically designed using colours, signs, memory orientation boards and memory box’s to aid people’s stimulation, independence and their wellbeing. This was in line with a number of different national best practice guidance documents.
Risks to people’s safety in the event of a fire had been identified and managed, for example, fire risk assessments and evacuation plans were in place.
We saw a complaints procedure was displayed in the main reception of the home. This provided information on the action to take if someone wished to make a complaint.
We found an effective quality assurance system operated. The service had been regularly reviewed through a range of internal and external audits. Prompt action had been taken to improve the service or put right any shortfalls they had found. We found people who used the service, their representatives and other healthcare professionals were regularly asked for their views.
We saw the home had received nine recognition of kindness awards (ROC) these were awards provided by the organisation following nominations from health and social care professionals and people’s representatives.