Gospel Oak Court

Staff had received regular, formal supervision from their line manager. We noted that annual appraisal of staff performance had not been carried out since 2017. Consequently, staff skills to perform their role had not been reviewed and the need for further training had not been explored with them.

New staff received an induction before they started supporting people. Other staff received mandatory training which was mostly up to date or was planned for the near future. We observed that staff required further training in dementia awareness and epilepsy, which was still to be scheduled at the time of our inspection.

Medicines were managed safely and people received their medicines as prescribed. We noted that records related to medicines non-administration and creams application had not always been clearly maintained. These had not always clarified why people refused to take their medicines and what creams people were using.

Risk to people's health and safety had been assessed and reviewed. However, some risk assessments could have more information on risk management strategies, to ensure all staff had easy access to it and could support people in a consistent way.

Care was provided with the consent of people. When people had reduced capacity to make decisions about their everyday care, staff had not always been provided with sufficient information on what decisions they could make and how staff could support them.

The senior management team had carried out monthly quality audits. Actions following these audits had been agreed, recorded and monitored to ensure highlighted shortfalls had been addressed. However, these audits had not been effective in identifying shortcomings identified by us during our visit.

The senior management team knew and understood their roles and responsibilities set by the Health and Social Care Act Regulations and current national guidance on best care practice.

Staff helped to support people to stay safe from harm and abuse from others. There were appropriate

safeguarding procedures in place and staff followed them. Safe recruitment procedures ensured that people were supported by suitable staff. There were enough staff deployed to support people when needed. Infection control measures used by staff helped to protect people from the risk of infections. Accidents and incidents had been recorded and discussed with staff to avoid reoccurrence.

People's needs and related risks had been assessed before they started using the service. We saw that support plans formulated were based on the initial assessment and explained how each assessed need would be met.

People were supported to have enough food and drink and had a diet that suited their nutritional requirements and personal preferences. Staff supported people to live a healthy life and have access to health professionals when needed.

People and relatives told us that the staff that supported them were kind and compassionate. Staff encouraged people to make decisions about their lives and were involved in their everyday care where possible. People's support plans had been reviewed together with people and their representatives when appropriate.

Staff respected people's privacy and dignity. People's preferences as to entering their flats was discussed with them and respected. We saw staff knocking on the door before entering people's flats. Peoples preferences regarding support of a male or female staff had been discussed with them and followed.

People's care plans were person centred and they outlined how people would like to receive their care, information about people's hobbies, religious and cultural needs and preferences. Where people had specific care needs, for example, continence management and epilepsy, this had been reflected in their care plans. Care plans were regularly reviewed and people participated in these reviews.

The provider had a complaints policy and people and relatives knew how to make complaints should they need to. Those who had made a complaint said their concerns had been addressed and resolved. We saw all three complaints received in 2018 had been dealt with promptly, as per the providers policy.

People were encouraged to have their say about the service. This could be done through periodic meetings, individual care reviews or formal complaints procedure. We saw that the service had been responsive to feedback received from people.

We made three recommendations which were related to staff appraisals and training, management of medicines and Mental Capacity Act 2005 (MCA).

More information is in the full report