4, 12, 13, 15 November 2013
During an inspection looking at part of the service
As part of this follow-up inspection, we talked to people who lived in the home and relatives. Most people who used the service spoke positively about the home, saying: 'on the whole, it's a happy place' and 'staff look after me.' One relative said staff were 'very good' with their relative but there were 'odd moments' when things were 'not so good'.
On 4 November, we saw that the provider still did not have appropriate arrangements in relation to obtaining medicine, as medications for six people had run out in October. We raised concerns with the provider, who acknowledged the concerns and sent us a letter on 5 November 2013 detailing the actions they had taken or planned to take to keep people safe.
On 12 and 13 November, we saw that the provider had made improvements in some areas, such as increased supervision of staff, improved understanding of people's preferences, and a better understanding of the Mental Capacity Act 2005. We also saw that staff adequately met people's nutritional needs, cooperated with other providers, and safeguarded people who used the service from abuse. Staff and people who used the service felt that staffing had improved but still expressed concerns to us about the deployment of staff. The provider took steps to ensure the premises and equipment were safe and suitable.
But, they still did not meet the requirements of the regulations in other areas. For example:
Although records relating to complaints had improved, the provider still did not have an adequate system for managing complaints. Records relating to staff did not contain all the information required.
We saw that, although staff had recently updated people's care plans which provided more detail about people's care needs, some care plans were still inaccurate. Staff still did not respond to deterioration in people's health in a timely way nor maintain accurate monitoring records according to people's needs.
We saw that the provider's system for monitoring the quality of the service did not identify concerns regarding inaccurate care records, out of stock medication, or the cleanliness of equipment.