Archived: Dawson House

Dawson House is a small home which provides care and accommodation for up to seven adults with learning disabilities, autism and complex communication needs. At the time of our inspection there were seven people living at the home.

The service is required to have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager left the service in November 2015. The provider appointed a new manager immediately. The new manager had submitted their application to CQC to become the registered manager for the home, which was being processed.

Relatives told us people were safe at Dawson House. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk. They knew how and when to report their concerns if they suspected someone was at risk of abuse. They had also received training to ensure people were protected from discriminatory behaviour and practices that could cause them harm.

Staff had access to appropriate guidance to ensure identified risks to people were minimised to keep people safe from injury or harm. Staff were aware of the specific risks to each person and what they should do to protect them. Regular maintenance and service checks were carried out of the premises to ensure the environment and equipment was safe. The provider had put measures in place to ensure risks posed by the environment were minimised. Staff kept the home free of obstacles and objects so that people could move freely and safely around.

There were enough suitable staff to support people. Staffing levels were planned to ensure there was a good mix of experienced and suitable staff on every shift to meet people’s needs. The provider carried out appropriate checks on staff to ensure they were suitable and fit to work at the home. Staff received relevant training to help them in their roles. Staff had a good understanding of people’s needs and how these should be met. Staff felt well supported by senior staff and were provided with opportunities to share their views about how people's experiences could be improved.

People were supported to keep healthy and well. Staff regularly monitored people's food and drink intake to ensure people were eating and drinking enough. Specialist diets were catered for and appropriate support was obtained for people with specific needs or conditions. Staff ensured people were able to promptly access healthcare services when this was needed. Medicines were stored safely, and people received their medicines as prescribed.

People had support plans which reflected their specific needs and preferences for how they were cared for and supported. These gave staff guidance and instructions on how people’s needs should be met. People were appropriately supported by staff to make decisions about their care and support needs and encouraged by staff to be as independent as they could be. Staff used different methods of communication to ensure people could be involved in making these decisions.

Relatives said staff were kind and caring. Staff acted appropriately to minimise distress or anxiety experienced by people. They were respectful of people’s privacy and dignity when supporting them. Staff were welcoming and relatives said they were free to visit the home with no restrictions. People were encouraged to maintain relationships with people that were important to them and to undertake social activities and outings of their choosing. People were supported to raise any concerns and there were arrangements in place to deal with their concerns or complaints, appropriately.

Relatives told us the service was managed well. The new manager demonstrated good leadership. They ensured people’s views were sought about how the care and support they received could be improved. They met regularly with staff and checked they were clear about their duties and responsibilities to the people they cared for and accountable for how they supported people to meet their care goals and objectives.

The provider and manager carried out regular checks of key aspects of the service to monitor and assess the safety and quality of the service that people experienced. The manager took appropriate action to make changes and improvements when this was needed. The service used external scrutiny and challenge to ensure that appropriate care and support for people on the autistic spectrum was being provided.

The provider had procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had received training to understand when an application should be made and how to submit one. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. Applications made to deprive people of their liberty had been properly made and authorised by the appropriate body. The provider was complying with the condition applied to the authorisation.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

A representative of one of the people using the service said they regularly observed the way staff interacted with their relative which gave them assurance they were safe in the home.

Senior staff regularly assessed potential risks to people's safety, health and welfare both within the home and in the community. There was appropriate guidance for staff on how to manage these risks to keep people safe from harm when they received care and support.

People were cared for in an environment that was kept clean and hygienic. Staff knew how to maintain good standards of cleanliness and personal hygiene to reduce the risk of cross infection. The home was free from clutter and obstacles which meant people were able to move freely around the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and in how to submit one. This means that people will be safeguarded as required.

Is the service effective?

People using the service and their relatives were involved in planning and developing their care and support. Their views and experiences were used to develop their plan of care. Their specific needs were taken into account and staff demonstrated a good understanding and awareness of these. A representative of one of the people using the service told us staff had a good understanding of their relative's needs.

Where people lacked capacity to make complex decisions about their care and support, family members, healthcare professionals and staff were involved in making decisions that were in people's best interests.

Staff encouraged and supported people to keep healthy and well through regular monitoring of people's general health and ensuring people attended scheduled medical and healthcare appointments. People were encouraged to eat a well-balanced, healthy and nutritious diet.

Staff received regular and appropriate training to ensure they were able to meet the specific needs of people using the service.

Is the service caring?

People were supported by kind and attentive staff. We saw staff showed patience and gave encouragement when supporting people. These interactions were warm, kind and friendly. A representative of one of the people using the service told us staff were caring and they had observed how comfortable their relative was with them.

Is the service responsive?

People met regularly with their keyworker to review their care and support. There was detailed information for staff about how people expressed themselves through speech, signs, gestures and behaviours. This was important as this helped staff understand what people wanted or needed or how they were feeling.

A relative of one of the people using the service told us they were comfortable raising any issues and concerns with senior staff and they dealt with these quickly.

Is the service well-led?

The provider carried out regular checks to assess and monitor the quality of service provided and took appropriate action to address any issues or concerns about service quality.

Senior staff demonstrated a good understanding and awareness of how regular audits and checks improved the service that people experienced.

The views of people using the service, their representatives and staff were listened to by senior managers.

We were informed that representatives of people using the service were in regular contact with staff at home and they also visited the home on a regular basis.

People were supported in promoting their independence and community involvement. People were given opportunities to express their choices and to make decisions in their daily lives. We observed that staff were aware of people's preferences and routines so they could support people in their daily lives. For example they knew at what time people preferred to eat and what time they went to bed or got up. From our own observations we saw staff treated people using the service with dignity and respect.