Archived: Derriads

Updated 12 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 13 September 2017 and was unannounced.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed all of the information we hold about the service, including previous inspection reports and notifications sent to us by the provider. Notifications are information about specific important events the service is legally required to send to us.

The inspection was carried out by one inspector. We spoke with one person and observed the interaction two people had with staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We asked for feedback from one relative, social and healthcare professional but none was received. We spoke with the four staff including relief staff and the registered manager.

We looked at documents that related to people's care and support and the management of the service. We reviewed a range of records which included three care and support plans, staff training records, staff duty rosters, policies and procedures and quality monitoring documents. We looked around the premises and observed care practices for part of the day.

Updated 12 October 2017

Derriads is a respite service operated by Wiltshire Council and provides short term residential care breaks for up to four adults with a learning disability. At the time of the inspection there were three people having a short break.

This inspection was unannounced and took place on 13 September 2017

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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.

Systems were in place to manage risk. The staff we spoke with knew the actions needed to protect people from the risk of potential harm. However, risk assessments were not in place for all risks identified. For example, moving and handling. While staff reported accidents and incidents the reports were not analysed to identify patterns and trends.

We found areas of the home needed repairs, flooring in some areas such as the foyer was heavily soiled and there was poor storage for equipment. Although the registered manager had reported the repairs, action was outstanding.

The principles of the Mental Capacity Act (2005) were not consistently followed by the staff. People’s capacity to make complex decisions was not assessed. We saw people were under continuous supervision and staff confirmed this but Deprivation of Liberty Safeguards (DoLS) were not considered or applied for. Staff had not considered that lap belts and bed rails were forms of restrictions and had not assessed this.

Care plans were generally person centred. For some people their life stories lacked detail such as education and the events that led to their admission. Person centred profiles for some people were brief and lacked detail. For example, future goals.

Systems in place to assess and monitor the quality of the service needed to improve. People’s views about the service or those people close to them were not gathered. While audits had identified similar shortfalls to the inspection findings action had not been taken to make improvements.

When we asked one person if they felt safe they agreed and said “yes”. However, people using the service at the time of the inspection were not able to tell us what feeling safe meant to them. Staff said they attended safeguarding of vulnerable adults training. Records confirmed this. The staff we spoke with knew the types of abuse and the expectations that they report abuse.

The staff we spoke understood the importance of developing positive relationships with people. Staff were knowledgeable about people’s likes and dislikes. We saw people accept staff support and there were good humoured interactions between people and staff.

Medicine systems were safe. Staff signed medicines administration records (MAR) charts to show the medicines that had been administered. Protocols were in place for medicines to be administered as required.

There was a system in place to determine the number of staff required for people on respite care. Staffing levels had improved with recruitment of new staff but there was a reliance on relief staff to cover absences and vacant posts.

Members of staff received effective support to meet their roles and responsibilities. New staff received an induction for the role they were employed to perform. Mandatory training set by the provider was attended by all staff to ensure they had the skills needed to meet people’s needs. Group supervision was monthly and staff had the opportunity to discuss work issues and changes in policies were shared. One to one supervision with the registered manager was on request by staff or by the registered manager to discuss performance.

Some people attended day care services during the week and at weekends, staff organised outings and in house activities.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.”