3 June 2014
During a routine inspection
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found:
Is the service safe?
We found the service to be safe because they had a range of policies and procedures in place to protect the people who lived in the home. The staff we spoke with had a good understanding about how to report any concerns.
We observed that staff were competent and professional in their interactions with people who lived at the home. The atmosphere in the home was relaxed and staff interacted with people in a kind and respectful manner.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.
Staff were able to provide safe, appropriate and personalised care to the people who lived at the home. Each person had a plan which described the care and support they required and how staff should provide it. These plans also included who the important people in their life were, how people communicated, daily routines, preferences and how they made decisions.
The care and support plans we looked at contained clear information about identified risks and how risks should be managed. Examples included supporting people to access the community and maintaining independent living skills. We saw that a plan of care had been developed to manage any identified risks in the least restrictive way. This meant that people could be supported with activities with reduced risks to themselves or to the people who supported them.
We observed that staff supported people to access the community in accordance with their plan of care. We saw that people were supported by appropriate numbers of staff.
Is the service effective?
We found the service to be effective because people's care treatment and support achieved good outcomes. We also found that people's rights and choices were respected by staff.
Staff told us they attended a handover meeting at the start of every shift. They said that this provided them with current information about the people they supported. We saw staff recorded information about each person on a daily basis. Information included how people had spent their day and how they had responded to activities of daily living. This meant the effectiveness of people's care plans could be fully reviewed.
We saw that people's prescribed medicines had been regularly reviewed by their GP or specialist health care professional. This meant that people received medicines which were appropriate to their needs.
Staff used a range of methods to assist people to make choices about their day to day lives. Examples included objects of reference and photographs. We observed staff offering people choices in accordance with their needs and preferences.
The service was effective in promoting people's independence and community involvement. People were supported to engage in the local community in a variety of ways. Examples included trips out, home visits, shopping trips and activities.
Is the service caring?
Staff interactions were kind, patient and professional and people appeared very comfortable with the staff who supported them.
We were able to meet with three people who were using the service. Communication was limited however people made the following comments 'I am happy. I like my flat' and 'Staff kind to me, yes.' We observed that people responded positively to the staff who supported them. For example one person smiled and gave a thumbs up when staff asked them if they would like to go to the pub. Another person made a sound which, staff told us, indicated that they were happy.
The staff we spoke with had a very good understanding about the needs and preferences of the people they supported. They understood and responded to people's needs and requests where individuals were unable to make their wishes known verbally. This demonstrated that staff knew people well.
Is the service responsive?
The service was responsive to people's needs. Staff had up to date guidance on how to support each individual. We read three care and support plans. These contained assessments of need and outlined how needs would be met. The assessments were regularly reviewed to ensure they reflected people's up to date needs and preferences.
Each person was allocated a keyworker who they would meet with on a regular basis. We saw the keyworker was involved in the review of people's care needs and preferences with other professionals.
Staff recruitment procedures had improved and now reduced any risks to people using the service.
The service had taken appropriate steps to ensure staff had the skills and equipment required to meet the changing needs of one individual with a rare and degenerative health condition.
People's health care needs were monitored and responded to appropriately. Information about people's health needs and contact with health and social care professionals had been recorded. We were informed that the service received good support from health and social care professionals and there were no problems obtaining their input for people when required.
Is the service well led?
The service was well led because there were systems in place which monitored the quality of the service provided. The service was proactive in seeking the views of the people who lived at the home and their representatives. We saw that the service responded to any comments or suggestions made.
The service was managed by a person who had been registered by the Commission. The registered manager regularly provided 'hands-on' care. This meant they remained up to date with the needs and preferences of the people who lived at the home. The staff we spoke with told us they received the training and support they needed. The manager had been proactive in seeking feedback from staff on their performance.
We spoke to the manager and three support staff. All were positive about the support they received and they confirmed that they received regular supervision sessions. Staff files contained detailed records of supervision sessions. These showed that staff received regular supervisions where their on-going performance and competencies were discussed.
We saw that staff had the opportunity to attend regular staff meetings. We looked at the minutes from a recent meeting. These showed that a range of topics had been discussed which included policies and procedures, staffing and information about the people they supported.
We found procedures were in place to minimise any risks to the people who lived at the home. Regular internal audits had been carried out which monitored the on-going health and safety of people. Internal audits included checks on the home's fire systems, environment, care planning and the management of people's medicines.