This inspection took place on 3 and 4 May 2016 and was unannounced. Derwent Lodge is registered to provide nursing and residential care and support for 16 people with mental health needs. At the time of our inspection there were 15 people using the service. The service is a detached, single storey property located within a residential area of Derby. The service provides communal rooms, which include lounges, dining room, activities room, smoking room and kitchen. The bedrooms are single occupancy with an en-suite facility. The service has a garden which can be accessed from the communal rooms.
Derwent Lodge had a registered manager 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.
People’s safety and welfare was promoted by staff that had a good understanding of the needs of people using the service. People had a key worker and co key worker who worked with them to develop plans of care which supported them with their recovery programme. People’s plans took account of potential risks to people and recorded how risks could be minimised whilst recognising people’s rights and choices in how they lived their lives.
Staff had access to an out of hours on-call system where they could seek advice from a manager or a member of the clinical team, to ensure concerns about people’s safety and well-being were managed well to promote their safety.
Recruitment procedures were robust and appropriate checks were carried out before people started work. Staff received a comprehensive induction and ongoing training. Staff were further supported through regular supervision and an annual appraisal to ensure they had the knowledge and skills to support people. Staff group supervisions were used to share information as to good practice and used as a learning opportunity to develop staff.
People’s rights and independence were fully understood by staff that had developed positive working relationships with people, which enabled them to provide the care and support people needed. People’s plans of care focused on their recovery and promotion of their independence across a range of topics, which included management of their own medicine and finances.
People were supported to develop cooking skills and to provide themselves with snacks and drinks. The main meal of the day was prepared and cooked by the chef and served by staff in the dining room. Staff encouraged people to eat their main meal in the dining room as part of people’s recovery to socialise.
People’s medicines were managed and administered safely following robust risk assessments to promote independence where possible. People’s consent had been appropriately obtained and recorded. Both staff and the managerial team understood the principles of the Mental Capacity Act and how they might apply to the people who used the service.
Staff worked in collaboration with people using the service and health and social care professionals to promote people’s health. People were encouraged to manage aspects of their own health and to attend appointments independently. People’s health care needs were regularly reviewed with the person using the service and a range of health and social care professionals.
Staff’s knowledge and understanding of the needs of people had enabled staff to develop working relationships with people, which meant people using the service were confident to receive support from staff. The atmosphere of the service was relaxed and people received the support they needed at a time that was appropriate to them.
People we spoke with told us how they managed aspects of their own lives and told us how staff supported them; they told us how their views were sought as to their individual goals and how they had the opportunity to attend meetings to talk about the service. We found staff to be proactive in motivating people to take part in activities, in some instances these had been identified by people as something they wanted to do. The approach of staff promoted people’s independence and confidence.
The provider had an effective system in place to assess and monitor the quality of the service. The views and opinions of people who used the service, staff and key stakeholders were sought, which included meetings, completion of surveys and internal audits.