The inspection team was made up of one inspector. We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who lived at the home, the staff who supported them and looking at records.
Is the service caring?
We spoke with three of the 18 people who lived at the home on the day of our inspection. They told us that they were happy with the care that they received. One person told us, "It is like any ordinary home. I'm happy here. I have no reason to be anything else."
Is the service responsive?
We saw that the manager had referred one person to the Community Adult Nursing Service when they had developed a blister on one of their heels. This showed that the manager obtained professional assistance when this was required.
People were not made aware of the complaints system. We saw that the home had a complaints policy. This was available to people who visited the home in a folder in the entrance hall. However, people who lived at the home were unable to access this as the door from the home to the entrance hall was kept locked at all times. We spoke with three people who used the service. They did not know that there was a complaints policy for the home. Two people did not know how to make a complaint.
We looked at the complaints record. This showed that no complaint had been received since 2012. However, one person told us that they had complained that some of their clothing had gone missing three weeks earlier. This complaint had not been recorded.
Is the service safe?
We looked at some comment cards that had been completed by visitors to the home. One comment was, "My [relative] is safe and this gives me peace of mind. The staff are committed to their job."
People's needs were assessed and care was planned in line with their individual care plan. We looked at the care records of five people who used the service. We found that these were personalised and detailed. We found that care had not been delivered in accordance with people's care plans. The care plan for dietary requirements for people who lived in the home identified that their weight should be monitored on a monthly basis. We found that people's weight had not been recorded since January 2014.
On the day of our inspection the home was free of any bad odours. The manager showed us around the building and we looked in a random selection of people's rooms, the communal areas including toilets, bathrooms and the kitchen. The manager told us that the home had been rated as a level four of five [good] by the local environmental officer for food hygiene. However, they were unable to evidence this as the relevant document could not be located. During our tour of the building we found several areas in which the standard of cleanliness was not met.
The manager confirmed that they had identified gaps in staff member's essential training and had taken steps to address this.
During the course of our inspection we identified that records that related to the management of the home were not readily accessible. The manager told us that they had been unable to locate essential certificates that related to safety at the home, such as checks of the gas and electrical systems.
Is the service effective?
We looked at the care records of five people who used the service. We found that these were personalised and detailed. Each contained a history of the person, information on their likes and dislikes and their personal preferences around times they got up, meal times and the time they preferred to go to bed. There were care plans that covered all aspects of people's lives.
The majority of people who lived in the home were living with some degree of dementia. However, only one of the care records we looked at had an assessment of people's capacity to make decisions about their care needs included. Where people did not have capacity to make decisions about their care, or had a lawful representative to make decisions on their behalf, we found that there were no best interest discussions recorded. The provider had therefore failed to act in accordance with legal requirements.
We saw that the provider had a policy for supervision and appraisal for staff members. This stated that a staff member should have five supervision meetings and one appraisal meeting a year with their manager. However, we identified that the policy had not been followed.
Is the service well led?
The manager had been in post for two weeks at the time of our inspection. They were an experienced manager who had transferred from another home within the provider's organisation.
We saw that the area manager completed monthly audits of the quality of service provided on behalf of the provider. The area manager showed us the results of the most recent audit, completed in May 2014. This audit had identified many of the shortfalls, particularly in the environment, that we noted during our inspection. We saw that an action plan had been developed by the area manager following this audit. However, none of the actions identified in the plan had yet been completed.