Background to this inspection
Updated
25 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 was a comprehensive announced inspection, which took place on 01 March and 07 March 2018. One inspector carried out the inspection. We gave the service 24 hours’ notice of the inspection, because Daubeney Gate is a small residential care home and we needed to be sure the registered manager, staff and people using the service would be in. On the first day of our inspection, we visited the service and on the second day, we spoke with relatives on the telephone.
We planned for the inspection by reviewing information the provider had sent us in the Provider Information Return (PIR). The PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed other information we held about the service including statutory notifications. A statutory notification is information about important events that the provider is required to send us by law. We also sought feedback from commissioners that monitored the care and treatment of people using the service.
During the inspection we spoke with three people about the care and support, they received from the service. Some people were unable to engage in conversation with us about their care so we observed them being supported by staff. We also spoke with two relatives and three staff that included the registered manager and two care and support workers.
We reviewed records relating to the care of two people, medicines records and storage, three staff recruitment records, staff training records, management audits and records relating to the management and quality assurance of the service.
Updated
25 April 2018
This inspection took place on 01 March and 07 March 2018 and was announced.
Daubeney Gate provides care for six adults with learning disabilities. The service provides 24-hour support to people, which enables them to live as independently as possible. The accommodation is over two floors with adapted bathrooms and enclosed garden areas. At the time of the inspection, six people were living at the service.
People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our last inspection, we rated the service as Good. At this second comprehensive inspection, we found that the service remained good.
There was 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.
Effective quality checks had not previously been carried out in order to check that the service was meeting people's needs and to ensure they were provided with a safe, quality service. Staff had not always received regular training and supervision to make sure they had the skills and knowledge to deliver effective care in line with best practice. The registered manager had taken steps to improve the governance of the service, however we needed to be sure they could be sustained and embedded into staff practice.
Staff followed the procedures for safeguarding people from the risks of harm or abuse. Risk management plans were in place to safeguard people’s personal safety and manage known environmental risks.
Staffing levels were sufficient to meet people's current needs. The staff recruitment procedures ensured that appropriate pre-employment checks were completed to ensure only suitable staff worked at the service.
Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Staff had the appropriate personal protective equipment to perform their roles safely. The service was clean and tidy, and regular cleaning took place to ensure the prevention of the spread of infection.
People’s needs and choices were assessed before they went to live at the service to make sure their care was provided in line with their preferences.
People were encouraged to shop for, prepare, and cook their own meals. Staff supported them to make healthy choices to maintain their health and well-being. Staff supported people to book and attend appointments with healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.
People’s diverse needs were met by the adaptation, design, and decoration of premises and they were involved in decisions about the environment. People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice
Staff treated people with kindness, dignity, respect, and spent time getting to know them and their specific needs and preferences. People looked happy and comfortable in the company of staff. Relatives told us they were happy with the way that staff provided support to their family members and that this was always carried out in a respectful and dignified manner. People were encouraged to make decisions about how their care was provided.
People were listened to, their views were acknowledged and acted upon, and care and support was delivered in the way that people chose and preferred. Care plans were person centred and reflected how people’s needs were to be met. People were supported to take part in activities that they wanted to do, within the service and the local community. There was a complaints procedure in place to enable people to raise complaints about the service.
There was nobody receiving end of life care at the time of our inspection. However, there were systems were in place and future planning documents to support people and their families when coming to the end of their life.
Staff worked well together and created a relaxed, friendly, and jovial atmosphere at the service. Staff were positive about the management and told us there had been previous difficulties with a lack of staffing but things had improved recently.