Background to this inspection
Updated
16 May 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.
The inspection took place on 20 April 2017 and was announced. We told the provider 24 hours in advance to ensure people and staff were available on the day of our inspection. The inspection was conducted by one inspector.
We reviewed the information we held about the service. We looked at information received from local authority commissioners. Commissioners are people who work to find appropriate care and support services for people and fund the care provided. We also looked at statutory notifications sent to us by the service. A statutory notification is information about important events which the provider is required to send to us by law.
We did not ask for a provider’s information return (PIR). This is a form we ask providers to send to us before we visit. However, during and following our inspection visit, we gave the provider the opportunity to give some key information about the service, what the service does well and improvements they plan to make.
The people living in the home were unable to communicate with us verbally, so we spent time observing their interactions with staff, how they responded and were supported. We spoke with three relatives following our visit on the telephone. We also spoke with the registered manager, the deputy manager and four care staff.
We reviewed four people’s care plans, to see how their care and support was planned and delivered. We looked at other records related to people’s care and how the service operated. This included medicine records, staff recruitment records, the provider’s quality assurance audits and records of complaints.
Updated
16 May 2017
This inspection took place on 20 April 2017 and was announced.
39-41 Derwent Road is a purpose built care home consisting of two bungalows. It provides care and accommodation for up to six people with learning disabilities. At the time of our inspection visit, six people were living at the home.
The service had a registered manager. 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.
The home was last inspected in April 2016, when we found the provider was compliant with the fundamental standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, the home was awarded an overall rating of 'requires improvement'. This was because, where people lacked capacity to make day to day decisions, this was not always assessed. We found applications to deprive people of their liberty under the Deprivation of Liberty Safeguards (DoLS) had not been made as required. We also found systems designed to check the quality and safety of the service provided were not always effective in identifying areas for improvement so these could be acted upon.
At this inspection, we found some actions had been taken to make the improvements required.
Where people lacked capacity to make decisions, this had been assessed and documented so people received the right level of support with decision-making. Where people were being deprived of their liberty, applications had been made to the local authority as required to ensure these were authorised and people’s rights were protected.
The provider had a range of measures in place to check the quality and safety of the service so that improvements could be made. They regularly consulted with people, their relatives and others to gather and respond to their feedback.
People were comfortable with staff, and relatives were confident that people were safe living in the home. Staff received training in how to safeguard people, and had access to the provider’s safeguarding policies and procedures if they had any concerns. Staff understood what action they should take in order to protect people from abuse. There were systems and processes used to identify and minimise risks to people’s safety. These systems were flexible so people could take risks to support their independence if they were able to do so.
People were supported with their medicines by staff that were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. Regular checks of medicines helped to ensure any issues of concern were identified and acted upon.
There were enough staff to meet people’s needs. The provider conducted pre-employment checks prior to staff starting work to ensure their suitability to support people who lived in the home. Staff told us they had not been able to work until the checks had been completed.
People told us staff treated them with dignity and respect. We saw interactions between people at our inspection visit were respectful, and the staff approach to people was also reflected in care records. People were supported to make choices about their day to day lives. For example, they could choose what to eat and drink and when, and were supported to maintain any activities, interests and relationships that were important to them.
People had access to health professionals whenever necessary, and we saw that the care and support provided was in line with recommendations. People’s care records were written in a way which helped staff to deliver personalised care, which focussed on people being supported in ways they preferred. Staff tried to ensure people were fully involved in how their care and support was delivered, and people were able to decide how they wanted their needs to be met.
Relatives told us whilst they had not had cause to complain, they were able to raise any concerns with the registered manager, and they would be listened to and responded to effectively, and in a timely way. Staff told us the management team were approachable and responsive to their ideas and suggestions.