The Dexters Limited

Updated 29 December 2017

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 registered 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 comprehensive inspection took place on 10 October 2017 and was unannounced.

The inspection was carried out by one adult social care inspector and one specialist mental health inspector.

Before the inspection, the registered provider was asked to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service including notifications about any incidents in the home. We requested feedback from the local authority contracts and commissioning team and they did not raise any concerns about the service.

During the inspection we spoke with seven people who used the service and one person’s relative who was visiting. We spoke with the registered manager, a team leader, a senior support worker, a support worker, an activities co-ordinator and the registered provider’s operations manager. We observed daily activities in the home including the support people received with their medicines and the interactions between staff and people who used the service. We reviewed three people’s care records, three staff recruitment records, induction and training records, and a selection of records used to monitor the quality of the service. We also received feedback from two health and social care professionals and one person’s representative (a court appointed deputy, who was authorised by the Court of Protection to make decisions on the person’s behalf) shortly after the inspection visit, who gave us their views of the service.

Updated 29 December 2017

The Dexters is registered to provide care and support for up to 21 people with mental health needs and/or learning disabilities. The home is situated close to York city centre. The main property is made up of two adjoining terraced properties which have been combined together to make up one larger building. The accommodation is over three floors. There is also a separate annex building, with three bedsits, at the rear of the main property. At the time of our inspection 21 people were using the service.

At the last inspection in September 2015, the service was rated Good. At this inspection we found the service remained Good overall and was now rated Outstanding in the key question: Is the service responsive.

The home had two registered managers, who shared joint accountability for the service. 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. One of the registered managers was the owner of the organisation, and the other registered manager had responsibility for the day to day management of the home and staff. Throughout this report, when using the term ‘registered manager’ we are referring to the registered manager who had responsibility for the day to day management of the home.

The support people received was extremely responsive to their individual needs. Staff were very knowledgeable about each person’s needs and preferences and highly detailed care plans were in place which enabled staff to provide personalised care. There was an extensive range of activities available to people, tailored around their individual skills, wishes and interests. Staff were especially skilled and creative in working in partnership with people to identify and organise their care and activities of interest to them. This had enhanced people’s well-being and quality of life.

People told us they felt safe and well cared for. Staff received safeguarding training and knew how to report any concerns. Risks to people were assessed and minimised, whilst promoting people’s independence and well-being.

Staff had been recruited safely and there were enough staff to assist people in a timely way. There were robust arrangements for supporting people with their medicines.

People were supported to have 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.

Staff received the training, support and supervision they needed to support people effectively.

People received appropriate support with their nutritional needs. People were supported to access a range of health services and we received very positive feedback from visiting healthcare professionals about the service.

People and relatives said staff were caring and we observed them to be kind, friendly and attentive. Staff treated people with dignity and respect and promoted their independence.

People and visiting healthcare professionals told us the home was well-managed. There was a robust quality assurance system in place which included the completion of daily checks and weekly audits in relation to the quality and safety of the service. People were asked for their views in individual review meetings and ‘tenant meetings’ and we found that these were acted on wherever possible. The management team promoted a very positive person-centred culture within the service.