Footprints

There was a registered manager employed at the service. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was responsible for the day to day control of the service.

People were protected from the risks of abuse, discrimination and avoidable harm. Staff knew how to report any concerns and felt confident that action would be taken. People's money was safely managed.

Risks were assessed, identified, reduced and monitored. Action was taken by staff to keep people as safe as possible. When people needed specialist equipment this was regularly checked to make sure it was safe to use. The premises were maintained to keep people safe.

People were supported by sufficient number of trained staff who knew them and their preferences well. There were contingency plans to cover any unexpected staff absences. Recruitment checks were completed to make sure staff were honest, reliable and safe to work with people.

People received their medicines on time. Medicines were stored, managed and disposed of safely. Staff were trained to support people with their medicines.

People received effective care from staff who were trained and supervised to carry out their roles. New staff shadowed experienced colleagues to get to know people and their preferred routines.

Staff understood their responsibilities under the Mental Capacity Act. Meetings were held with the relevant parties to make decisions in people's best interest. Consent and agreement had not been formalised when people had restraints in place, like bed rails or wheelchair lap straps.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance

People were supported to have a balanced diet. People were involved in decisions about what they ate.

Staff monitored people's nutritional needs to help them stay healthy. Risks to people with complex eating and drinking needs were identified and monitored.

People were supported to maintain good health. Staff worked closely with health professionals, such as GPs and community nurses, and followed advice given to them.

People were treated with kindness and compassion. People looked happy and smiled at staff. Staff knew people and their families well. People's needs, preferences, likes and dislikes were recorded.

Staff used different ways to communicate with people and were patient, giving them time to respond at their own pace.

People's privacy and dignity were both promoted and maintained by staff. Staff spoke with people and each other in a respectful way. People's religious beliefs and cultural needs were discussed and recorded.

People's loved ones were able to visit when they wanted and there were no restrictions on this.

People's preferences and choices for their end of life care were discussed and clearly recorded. People had access to support from specialist palliative care professionals when needed.

People and their relatives were involved in the planning and reviewing of their care. People's care plans were an accurate reflection of people's choices and centred on them as an individual. People's independence was promoted. Care plans included pictures and symbols to make sure they were easy to read.

People, relatives and stakeholders were encouraged to provide feedback on the quality of the service. Complaints were investigated in line with the provider's policy.

People and their relatives had built strong relationships with staff. People had lived at the service for a long time and knew the other people living there well and had formed friendships. People were empowered to build strong links with the local community.

There was a culture of openness, inclusivity and empowerment which was promoted by staff. Clear visions and values were understood and promoted by staff to make sure people received care and support in a dignified, respectful and compassionate way.

The registered manager led by example, motivating, mentoring and coaching staff on a day to day basis to provide safe and effective levels of care and support.

Robust auditing processes were in place to check the quality and safety of the service provided. The registered manager had submitted notifications about important events that happened to CQC in an appropriate and timely manner and in line with guidance.

The five questions we ask about services and what we found