16 October 2019
During a routine inspection
Derwent House is a residential care home providing personal care for people who have a learning disability.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people but only 12 people were being supported at the time of our inspection. This is larger than current best practice guidance detailed in Registering the Right Support. The provider had started to work towards meeting best practice guidance and staff were encouraging people to be more independent and more involved in the service.
People’s experience of using this service and what we found
The provider’s legal entity was registered with us as a partnership and remained inappropriate at this inspection due to concerns that had been raised about the partnership. Action still needed to be followed to ensure the new company registration continued. The oversight of the service needed improving to ensure areas of concern and areas to improve were identified and acted upon.
Staff required further training to ensure their knowledge was fully effective at ensuring people received the best support possible. People were not always supported to have maximum choice and control of their lives and although staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support ensuring decisions made were in people’s best interest.
Medicines management required improving to ensure people had access to effective medicines and staff had sufficient guidance to know when to administer medicines. Staff understood their safeguarding responsibilities. People had risks to their health and well-being assessed and planned for. People were protected from the risk of cross infection and improvements were still being made. People were supported by enough safely recruited staff.
No one was receiving end of life care, we made a recommendation about ensuring people’s end of life preferences were planned for. No complaints had been received but the registered manager was aware of their responsibilities. We made a recommendation to ensure the complaints procedure on display was correct. People were supported in line with their communication needs. People had care plans in place which explored their preferences about how they liked to be supported. Activities were available for people to partake in.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service had started to reflect the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having opportunities for them to gain new skills and become more independent.
People were involved in meal planning and could access food and drinks of their choice when they wanted them. People were supported to access other health professionals and were encouraged to remain healthy and had their needs assessed.
People were treated with kindness and respect by a caring staff team. People had their independence promoted and were encouraged to partake in decisions about their care.
People and staff felt positively about the registered manager and felt supported in their role.
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 requires improvement (published 11 July 2019) and there were multiple breaches of regulation; and was rated inadequate in well-led. At this inspection the service had made some improvements and there was one remaining breach of regulation. The service remains rated requires improvement.
This service has been in Special Measures since 06 November 2018. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was planned to follow up on the concerns at the last inspection in line with our ‘special measures’ procedures. We needed to check that people were supported safely and whether the provider was meeting the Regulations.
We found improvements had been made. However, there were still improvements needed to ensure people received good support in relation to all key questions. We rated the key questions of safe, effective and well led as requires improvement. The overall rating is requires improvement.
Enforcement
We have identified a breach in relation to ensuring directors are fit and proper persons at this inspection. Please see the action we have told the provider to take at the end of this report.
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.