This comprehensive inspection took place on 13 and 14 August 2018. The first day of the inspection was unannounced. We told the provider we would be returning on the following day to continue to review the care people received in the service.
On the first day of the inspection the inspection team consisted of one adult social care inspector, two specialist advisors, one of whom was a nurse and the other a pharmacist, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert had experience of residential care services. The second day of the inspection was carried out by one adult social care inspector.
Before the inspection, we reviewed the information we held about the service including notifications the provider had sent to us. A notification is information about important events which the provider is required to send us by law. We also contacted the local safeguarding and quality assurance teams, the local clinical commissioning group and the local Healthwatch team to gather their views about the service. We included the information provided to us in our inspection plan for the service.
During the inspection we spoke with eight people who used the service across all three households and six visitors. We also spoke with a total of 16 staff employed in the service. The staff we spoke with were the registered manager, the assistant manager, a registered nurse, two senior support and activity workers, five support and activity workers, the activity coordinator, the facilities officer, a kitchen assistant and three members of the housekeeping team.
We carried out observations in the public areas of the service. We also undertook a Short Observation Framework for Inspection [SOFI] on the ground floor household which provides nursing care to people living with a dementia. A SOFI is a specific way of observing care to help us understand the experiences of people who could not talk with us.
We looked at the care and medication records for six people who used the service. In addition, we looked at a range of records relating to how the service was managed; these included three staff personnel files, staff training records, staff supervision and appraisal records, minutes from meetings, incident and accident reports, complaints and compliments records as well as quality assurance audits.