This inspection took place on 14 February 2018 and was unannounced.At our last inspection in August 2017 we found the provider was in breach of five regulations: Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider failed to assess and monitor people’s health care needs and this place people at risk of deterioration in their well-being. At this inspection we found action had been taken to reduce these risks. The provider also failed to ensure people received safe care and treatment. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Improvements were found at this inspection and people were safe. The provider also failed to ensure that people were protected from abuse and improper treatment. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Improvements were noted at this inspection. We also found at the last inspection that the provider’s systems failed to identify, monitor and act upon poor care and treatment and they failed to ensure people were supported by staff who had the knowledge, skills and experience to meet their needs. Improvements were noted at this inspection and people were supported by staff who were trained and knew people well.
Darwin Place is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Darwin Place accommodates a maximum of seven people who have a learning disability or autistic spectrum disorders. Accommodation is set up across four separate units, each of which has separate adapted facilities.
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. Registering the Right Support CQC policy
At the time of the inspection there were three people living at the home.
At the last inspection in August 2017, the service was rated Inadequate and was placed into special measures. Following the inspection we took urgent enforcement action to restrict any admissions to the home.
This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.
At this inspection we found the service had improved to Requires Improvement overall with a rating of Requires Improvement in the Well-Led domain. There were no breaches of our regulations. However the provider needs to demonstrate the improvements made can be maintained consistently over time and when more people move into the home.
Since the last inspection there had been a change in manager who was yet to register with us. 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.
People were now supported by adequate numbers of staff who had the skills and knowledge to meet their needs. Staff knew how to protect people from the risk of harm and abuse. There were now systems in place to identify and manage risks and to protect people from harm or abuse. People received their medicines when they needed them and medicines were stored and managed in a safe way.
People were now supported by a core team of staff who knew them well. Staff had the skills and training to meet the needs of the people who lived at the home. Communication systems had improved which meant the effectiveness of people’s plan of care could be reviewed. 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 supported this practice. People were supported to eat well in accordance with their needs and preferences. People saw health care professionals to ensure their needs were met.
People now lived in an environment which met their needs and promoted their well-being. Staff were kind and considerate and people’s right to privacy was respected. People were supported to exercise choice and control over their lives.
People now received a service which was responsive to their needs and preferences. Staff knew what was important to the people they supported and people were involved in planning and reviewing the care they received. There was a varied programme of activities which were based on people’s preferences.
There were improvements in the provider’s systems for monitoring the quality of service people received. However more time is needed to ensure systems can be maintained consistently over time and when more people move into the home. Staff morale had improved and staff felt supported in their role.
Further information is in the detailed findings below