Gilburn

We reviewed all quality statements in the Safe domain. Since the last inspection improvement has been made to staffing levels. Staff reported there were enough of them to provide the support people needed, and the registered manager had responsibility for managing the rotas. Staff were knowledgeable regarding people’s needs and associated risks. Care plans and risk assessments were regularly reviewed and contained information on recognising deterioration, and how and when to seek support from relevant health and social care professionals. Environmental checks and infection prevention control systems were in place and effectively used. People were supported with medicines, however processes were not always effective in identifying errors and did not always provide information on best practice.

We reviewed all quality statements in the Effective domain. People’s needs were assessed, reviewed and updated in care plans and risk assessments by leaders at the service. Information was available to staff who had time to read and understand relevant documentation. Staff were trained in a variety of areas to ensure they had relevant skills and knowledge to undertake their role. People’s capacity to make decisions were assessed and appropriate legal processes were in place for those who had some restrictions around their care in place. Staff understood people’s right to make decisions and worked to de-escalate risk and divert people, using restraint practices as last resort measures.

We reviewed all quality statements in the Caring domain. People were supported by staff who were caring. Staff were passionate about providing person centered care to all, and were focused upon ensuring people had positive daily and long term outcomes. Staff encouraged people to be as independent as possible and assisted them in areas where required. Systems and processes were in place which allowed leadership to focus upon staff wellbeing which was positively reflected in feedback provided by staff through this assessment process.

We reviewed all quality statements in the Responsive domain. We found people were supported by staff to ensure their health needs, experiences and outcomes were positive and met. Staff had time and access to care plans which detailed people’s backgrounds, preferences and protected characteristics. This enabled staff to support people in ways that were meaningful to people and allowed them to feel comfortable. Processes and systems were in place which supported these practices. Where there were shortfalls, these were identified due to the systems being effectively used.

We reviewed all quality statements in the Well-led domain. There was an inclusive and positive culture at the service. Since the last inspection significant changes to leadership and staffing had led to a shift in the culture of the service, which placed people more centrally and ensured person centred care was being delivered. Systems and processes were in place to monitor care and ensured people were experiencing positive outcomes in all aspects of their lives.