Kalmia & Mallow

Right support The management of risks, including those posed by the environment, required further improvement. Recording and monitoring of known risks was not always accurate and staff knowledge of risk was not comprehensive. This placed people at risk.

Safeguarding incidents were investigated, and the provider took action to reduce future risks. Staff understood their safeguarding responsibilities and there were enough staff to meet people's complex needs. Infection control practices were good but the poor state of some areas of the building made the risk of infection harder to manage. A scheduled refurbishment programme began during our inspection period. Medicines were administered safely.

Right care Care plans reflected people's needs and choices and people were involved in decisions about their care. Records did not always document how often people had been supported to access the community to follow areas of interest. The provider was continuing to prioritise access to outside activities and relatives told us they had noticed improvements since the new manager had been appointed.

The model of care and setting was designed to maximise people's choice control and independence. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were included in decisions about their care and support.

Right culture Staff treated people who used the service in a way which upheld their dignity, privacy and human rights. Some written and verbal language needed to be more person centred.

Oversight of some aspects of the service required improvement. The provider had recognised this and was introducing a new recording system to address this. The new manager had made a positive impact on the service in a short time, supported by staff and senior management. The provider gave us assurances they understood where the improvement priorities were and would continue to work on these. There was a clear ethos in place and the provider's values promoted inclusion and empowerment for the people who used the service. There was still work to do to fully embed these values but the direction for the service was clear.