During this inspection we looked at how well people were cared for, how the service worked in cooperation with other agencies to ensure appropriate planning took place. How peoples dietary need were being met and managed. How the home recruited staff to ensure they were safe and competent to meet the needs of people living at Duxbury House. What quality monitoring systems were in place. We also looked at what systems were in place to enable people to raise comments and concerns about their care and treatment and whether this was effective in keeping people safe.Information we gathered during the inspection helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, staff supporting them, and from looking at records. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Duxbury House.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People were treated with respect and dignity by the staff. People told us they felt safe living there. Comments included, 'Since I have been here I have come on leaps and bounds. All the staff are very supportive'. Also, 'I go out nearly every day with my keyworker. I couldn't do without her'.
Systems were in place to make sure staff learn from events such as accidents and incidents, complaints, concerns and whistleblowing investigations. This reduced the risks to people and helped the service to continually improve. The provider/manager told us they took all incidents seriously and gave examples of where they had used experiences of incidents to adapt change. For example, working with other professionals to enable a more appropriate placement for people whose needs had changed.
The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards, although no applications had needed to be submitted. All staff were enrolled to undertake the relevant training in mental capacity in the near future. This would enable them to understand when an application should be made and how to submit one. This meant people would be safeguarded as required.
Maintenance service certificates were in place and up to date to ensure systems in the home were safe.
Is the service effective?
People's mental health and care needs were assessed with them, and they were involved in developing their plans of care where possible. One person we spoke with told us, 'My keyworker always talks things through with me, so does the manager'.
Systems were in place to monitor peoples dietary needs. This had been identified in support plans so staff could deliver an effective nutritional plan to meet individual needs. Examples of this included two people who had reduced their weight based upon healthy eating and exercise plans. One person told us, 'I never thought I could manage to lose weight like this but it's been so easy with the help I have been given'.
People we spoke with told us the service was flexible to meet their individual needs. 'I like the fact I can do the things I want but with the support of the manager and staff. It's made my life easier'.
In order to deliver effective care the provider/manager and staff demonstrated an understanding of the needs of people living at the home. Staff we spoke with told us they worked well as a team to ensure peoples needs were being met. One said, 'It a small home and we all communicate well so information is being passed down all the time'.
Is the service caring?
People were seen to be supported by attentive and respectful staff. We saw that care workers showed patience and gave encouragement when supporting people. Most people who lived at Duxbury House were independent and were supported to go out with staff. Some of the comments from people we spoke with included, 'I don't know what I would do without F'., she is always on hand for me'. Also, 'Great bunch of staff, always around when you need them'.
We spent time speaking with people about the level of care they provided. Staff we spoke with told us it was a role they were proud to work in. 'I love working here, it's just a very caring environment and people are appreciative of the care they receive'. People were seen to be supported by kind and attentive staff. We saw staff showed patience and gave encouragement when supporting people.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with their wishes. Personal profiles had been developed by staff. Staff we spoke with told us this had helped them to understand things that were important with individual residents. For instance once a month a member of staff accompanies a resident to a venue which enables them to take part in a personal interest of theirs.
Is the Service Responsive
People had access to a range of literature relating to the complaints procedure. People we spoke with said they knew how to make a complaint if they were not satisfied with something that affected them. One person told us, 'I always say if I am not happy with something. They always seem to listen to me and get it sorted out. Staff we spoke with told us a system was in place to investigate record and reach outcomes for any complaints they received. People could therefore be assured complaints would be investigated and action taken as necessary.
Is the service well led
The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a range of quality audit systems in place. We saw they were complete and up to date. They covered the environment, health and safety as well as staff and resident meetings. As a result the quality of the service was continually improving.
Staff told us they were clear about their roles and responsibilities. Staff had an understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.