Derwent Cottage

Updated 17 March 2022

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.

As part of CQC's response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 24 February 2022 and was announced. We gave the service 24 hours notice of the inspection.

Updated 17 March 2022

About the service

Derwent Cottage is registered to provide care and accommodation for up to four people with profound learning disabilities and/or autism. At the time of our inspection four people were living at this service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

People’s experience of using this service and what we found

The leadership and team working within this service was exceptional. This ensured everyone received high quality and personalised support. The history of this service showed the provider, registered manager and the staff team worked in partnership to continuously improve and this achieved the best outcomes for people. Everyone without exception, praised the leadership and compassionate approach within this service. Staff were responsive to people’s needs, whilst supporting them to learn new skills to improve their health and well-being. Health professionals described the service as; “Refreshing" and "The best I have experienced."

The leadership encouraged staff to approach people in a person-centred way, understand their needs and remove barriers to exceed expectations. People achieved positive outcomes through staff exploring and being innovative in the way they supported them. People’s independence was encouraged by staff that were creative in finding ways to enable people’s living skills to flourish. Activities, events and therapies were adapted to each person’s needs to support social inclusion and promote choice whilst considering people’s preferences.

Staff cared for people like they would their own family members. Relationships between people, staff and the registered manager were exceptionally proactive. People trusted staff that knew and understood them exceptionally well. Records and observations showed management and staff responded proactively to known risks to people and the aftercare with and without input from health professionals was taken above and beyond normal practices.

The service demonstrated the remarkable achievements made to improve people’s quality and experience of life. Relatives told us, “The service worked closely with teams of health professionals and in the wider organisation to look at ways to improve outcomes and support individual achievements. Step by step processes had been introduced, people had gained new skills, become settled in themselves and responded positively. Staff were self-aware and listened to people expressing themselves before considering the best way to support each person.

The service demonstrated positive outcomes for people which reflected the principles and values of Registering the Right Support. This included supporting people to make their own decisions and choices to maintain independence and control of their lives. People’s life experiences were improved by staff accessing the right support at the right time, to maintain positive outcomes for people’s health conditions. The service ensured people’s rights were upheld and advocated on their behalf when necessary. This meant people received timely care and support from health professionals and other agencies, which had a positive impact on their lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice. People and their relatives or representatives were fully involved in all aspects of their care. People’s aspirations were considered, and relatives involved in nurturing these achievements which encouraged people’s participation. The vision and values were embedded in the culture of the service, staff were committed and focused to deliver care that supported people to achieve their own goals and aspirations.

Staff knew the importance of asking for people’s consent before delivering care and support to them. Staff knew how people expressed themselves and were mindful to ensure they were settled and happy before proceeding.

The registered manager had a wealth of experience and exceptional leadership skills. The staff team communicated exceptionally well to deliver the best outcomes people could achieve. The registered manager was constantly encouraging staff to look at ways they could enhance people’s lives.

The registered manager and staff put people at the heart of everything they worked towards. The working relationships between people and staff were extremely productive and harmonious. Peoples well-being had significantly improved, some over a short period of time. This showed how the service succeeded in delivering high quality care and support in partnership with people.

Since the last inspection, the service had continued to review processes and introduce new initiatives to support achievements and people’s life skills and independence. Where positive outcomes had been achieved this practice was shared with other staff that managed services run by the same provider. The registered manager at this service took an active role in auditing and supporting other services to achieve outstanding ratings.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with, or who might have, mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. At the time of our inspection the service did not use restrictive intervention practices.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Outstanding (published 18 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.