Fortress Care Services

Staff were trained to administer medicines and their competency was assessed. This helped to ensure the person received their medicines as prescribed. Staff knew the person well. However, the guidance did not provide any guidance for staff on how to recognise if the person may be in pain. This meant any new staff may not know when to offer pain relief. Shortfalls in staff guidance for medicines prescribed "when required" had been highlighted at our previous inspection.

Records did not always provide consistent or complete guidance in how to meet the person's needs. A live- in care worker provided the person's care most of the time and knew the person extremely well. Their breaks were covered by a relief member of staff who also knew the person well. However, there was not sufficient guidance to ensure all the person's needs would be met should new staff provide their care.

Risks had been assessed in relation to the person's care. However, risks for staff, which could impact on the care the person received, had not always been formally assessed. These included the main care worker working for long periods of time without a break.

The provider and registered manager did not demonstrate they could implement new government guidance. For example, they had not implemented a system for staff to be tested for COVID-19 in line with current good practice guidance.

The provider had not employed any new staff since the last inspection. This meant we were unable to test their recruitment and induction processes.

Staff members had received training relevant to their roles. Staff felt well supported by the management team and received regular supervision and appraisal.

The person was supported to have maximum choice and control of their life 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.

Staff supported the person to maintain a healthy diet and to access healthcare services when needed. They liaised with health and social care professionals and followed their instructions.

Care staff were very caring and the relative was happy with the care their family member received. Care staff supported the person to maintain contact with people important to them.

The relative knew how to complain and was confident any concerns they raised would be addressed within the service. No complaints had been made since the last inspection.