1 – We looked at care plans and associated documentation for three people, two of whom had highly complex needs and a third person who started living at the home recently. We found that the assessment, planning and delivery of care were coordinated and centred on the needs and preferences of the individual.
2 – A thorough assessment was undertaken for each person by the manager, either at home or in hospital. Two of the people whose files we saw were referred by the dementia crisis team as an emergency.
3 – The daily plan and night plan described what people were able to do for themselves, demonstrating that their independence and dignity were promoted.
4 – People’s preferences were included in the guidance. For example one person with highly complex needs preferred to be alone. We saw from the documentation how the manager and staff had worked with the person to get to know them over time and establish trust so that their care needs could be met safely and their wellbeing monitored.
5 – The manager told us that staff were encouraged to focus on who the person is and what they could do for themselves rather than on the dementia as that would not give a true picture. We found that staff clearly knew people well and spoke of them with affection. Staff spoke kindly to people and supported them in an unhurried way.
6 – We saw that people were encouraged to be independent when eating, and support was provided as required to help people with their lunch.
7 – We observed that mealtimes were flexible. Several people were having a late breakfast at the start of the inspection.
8 – Snacks were available outside of mealtimes. People were encouraged to eat fresh fruit and had small bowls of grapes, banana or satsuma segments on their tables. We saw that people were regularly offered hot drinks and jugs of cold drinks were available.
9 – We saw how people using the service and their families were involved in developing the menus. The manager showed us the results of a Food Tasting Evening which had taken place during the previous October. Meetings were regularly held for residents and relatives, and this tasting session was held during such a meeting. People tasted three main meals and three desserts and were supported to give their opinions. We saw emails from those who had attending saying how successful it had been and how delicious the food was.
10 – We saw that people were protected against the risk of over or under medication because there were individual protocols in place for the administration of medication to be given as required (prn). These clearly described the indications for a dose to be given.
11 – People were safe because the agency had effective recruitment procedures in place to ensure that staff were fit for their role. We looked at recruitment files for two staff.
The application form was thorough, and provided much of the information required to be held. We found that appropriate checks were undertaken with the Disclosure and Barring Service and the Independent Safeguarding Authority and staff did not start until these were confirmed. Two references were on file for each person.