Note1 Oct 2025
Provider sought regular feedback from people using the service and relatives, who found them approachable.
Note1 Oct 2025
Staff supported people well with eating and drinking, with food nicely presented and kitchens kept clean.
Note1 Oct 2025
Some improvements to care plan format since last inspection, with recent reviews completed in January/February 2018.
Note1 Oct 2025
Staff received training in safeguarding, infection control, and the Mental Capacity Act 2005.
Note1 Oct 2025
Some individual carers demonstrated excellent, compassionate care and were highly praised by people and relatives.
moderatestaff_competency1 Oct 2025
live-in carer told us about their condition but they did not know what it was and could not tell us if anything made the condition better or worse.
moderateperson_centred_care1 Oct 2025
We found no information relating to people's religious or cultural needs...One person's plan did not mention that the person considered themselves both deaf and blind.
criticalleadership1 Oct 2025
The provider was not always open, honest and transparent...Sometimes we identified concerns and key information by chance when looking at other matters.
criticalincident_learning1 Oct 2025
There was no evidence that the provider fully investigated incidents and learned from them to drive improvement as we found concerns at this inspection mirrored those we had found previously.
moderatecomplaints_handling1 Oct 2025
a formal complaint from a healthcare professional had not been investigated...The provider failed to carry out a timely investigation into a complaint made by a healthcare professional.
moderatesupervision_appraisal1 Oct 2025
supervision of staff, especially live-in staff, was very infrequent...We saw very few records of staff supervision and no recorded sessions for some staff.
moderaterecord_keeping1 Oct 2025
information, such as that about recent falls or involvement of healthcare professionals had been archived...files were stored in the garage which meant we could not be assured of the security
criticalgovernance1 Oct 2025
three people had had falls in the last year that needed attendance at A & E...The provider had failed to notify us of these serious injuries
moderatemedication_management1 Oct 2025
We found no accurate stocktaking which meant we could not check to see if people had received the correct amounts of medication.
moderatestaff_training1 Oct 2025
one person had last had moving and handling training 11 November 2015. One member of staff only had a multi topic certificate issued by the provider on 23 March 2017.
criticalstaffing_levels1 Oct 2025
We were not assured that this level of staffing ensured enough flexibility to cope with a sudden absence of a key member or members of staff.
criticalsafeguarding1 Oct 2025
the provider had only recently made this referral in January 2018 when the issue was identified during our August 2017 inspection. This did not demonstrate a proactive approach to safeguarding
criticalcare_planning1 Oct 2025
one person's falls risk assessment dated 1 February 2018 stated that the person had had no falls in the previous year...We found that this person had a significant fall on 10 January 2018