Derby House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were supported to take positive risks towards independence using a creative and comprehensive approach to risk taking. Staff we spoke with demonstrated a clear understanding of what abuse was and how to manage and report any situation of this kind. Safe recruitment processes were used in line with the provider's recruitment policy to ensure staff employed were suitable to work with vulnerable people. There were sufficient numbers of staff available to be able to meet the needs of people who used the service. There was an effective system in place to manage people's medicines.However, we found some areas of the homes needed updating and maintenance. We discussed this with the provider, who was already addressing these concerns.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People's quality of life was enhanced by the service's culture of improvement and inclusivity. One person said, “This service is amazing; the staff are amazing. I could not have done what I have done without them.”

Staff said there was a proactive culture of safety, in which concerns about safety were listened to and acted upon.

There was a robust process in place to monitor incidents, accidents, and near misses. Staff recognised incidents and reported them appropriately, and managers investigated incidents and shared lessons learned. Senior staff maintained a record of accidents and incidents and reviewed regularly to look at patterns and trends.

People said they felt 'listened to' and 'safe'. One person told us their life had got better because of the support staff gave them. They went on to say they were involved in their reviews when and if they wanted to be.

Staff told us they were given information on how to support people who were new to the service and that care plans were frequently updated when needs changed. They were able to give us examples of individuals and the specialist teams they had been referred to for support, such as the Mental health team when people had experienced increased anxieties.

Partners gave positive feedback about the service and their ability to develop close and effective relationships with partners to manage the best interests of the people they supported. One professional said, “The partnership working with the provider was excellent and this enabled efficient and excellent care.”

The provider had processes in place to ensure safe system, pathways and transitions were maintained. This included an initial needs assessment at the start of a service being provided and personalised care plans to share important information when needed.

People and their relatives told us the service was safe. One person said, "Without doubt I feel safe living at Derby House, the staff are always around to help when I need it."

Staff demonstrated they were highly skilled at recognising when people felt unsafe and were confident when challenging and reporting unsafe practice. They knew from people's body language and actions if a person felt unsafe or were worried about something. Staff told us they would give people time to talk and recognise if there were any changes in their behaviour that they felt might need to be reported due to safeguarding concerns.

We observed staff speaking to people in a respectful manner and including them in decisions. We saw staff responded promptly when people were feeling anxious or needed support.

Staff received training and had access to relevant information and guidance about protecting people from harm. Staff understood what was meant by abuse and were confident reporting safeguarding concerns. Any safeguarding concerns were recorded appropriately and reviewed to ensure the relevant professionals were notified. The provider was able to work with people to understand what being safe means to them as well as with our partners on the best way to achieve this.

People were involved in managing their risks. One person said, "I am really grateful to them [staff]. I can't speak highly enough of them [staff].Especially the [registered manager] they have gone through everything with me and stuck by me. I love [registered manager] they saved my life.”

Staff said people were supported to take positive risks towards independence. Staff told us they were able to keep people as safe as possible, whilst also promoting their independence and mental wellbeing.

Staff interactions were courteous, respectful and patient. We observed staff providing support in a positive and supportive way using respectful language and people were comfortable talking about their mental health.

Risk assessments fully addressed people's diverse needs. For example, people's specific needs around their mental health needs, addiction, self-care needs and chosen lifestyles. Risk assessments allowed people as much freedom as possible and promoted independence. Staff completed regular checks on the premises and equipment to ensure people's safety. This included checks by external contractors on gas, electrical and fire safety.

People told us they were happy with the environment. People told us they were supported by staff to keep their home clean and tidy.

Staff were aware of their role and responsibility in maintaining a safe environment for people who used the service. Staff confirmed they had completed fire safety training and evacuation procedures and had guidance about how to respond to an event that impacted the safe running of the service.

Observations found the environment, premises and equipment were maintained but in need of updating. The registered manager agreed areas of the services needed updating and repair and they shared with us a plan for improvements within the home.

The registered manager had excellent oversight of the service and regular assessments of the premises, both internal and external were completed and any repairs or risks identified were dealt with promptly. There were service certificates in place to ensure all equipment was in good working order.

People spoke with warmth about the staff. They said staff were respectful and caring in their approach and they were always available when they needed help or support. One person told us, “My life’s got better because of the support of the staff. The staff are amazing.”

Staff told us they received a thorough and in-depth induction prior working. They completed a range of training to give them the skills and knowledge to support people, this included completing qualifications in health and social care. One staff member said, “Working here has empowered me to develop my skills and knowledge. It's an amazing service to work in. I absolutely love working here.”

We observed relaxed and respectful interactions with staff. There was a lot of banter and laughter. The home felt calm and relaxed. There were sufficient staff to meet people’s needs when they required staff company or support.

Safe recruitment processes were used in line with the provider's recruitment policy to ensure staff employed were suitable to work with vulnerable people. Records showed that staff received training relevant to their role. Staff received the support they needed to deliver safe care. This included supervision, appraisal and support to develop. Effective systems were in place to ensure safe staffing levels were maintained.

People did not have any specific feedback in this area.While the people we spoke to said they were happy with the environment, our assessment found elements of care did not meet the expected standards.

Staff said they had received appropriate training in infection prevention and control and were aware of safe hygiene practices. While the staff we spoke to had no concerns about the infection and prevention control systems we found elements of care did not meet the expected standard.

We observed some areas of the service needed repair or replacement and therefore, could not be effectively cleaned. Staff completed regular cleaning with appropriate products. However, their efforts were compromised by the poor state of repair of the home which meant some touch points were difficult to clean effectively.

Infection control systems were in place. However, some areas of the service needed repair or replacement and therefore, could not be effectively cleaned. This was discussed with the registered provider who said there was a service improvement plan in place, and they would take action to ensure the service was well maintained. The provider had cleaning schedules in place to make sure all areas were kept hygienically clean. Audits were carried out to make sure high standards of cleanliness were maintained.

People told us they were supported to take their prescribed medicine and that they were able to ask for pain relief when necessary. One person told us, “The staff know when I am feeling low, and they will ask me if I want my medicine.”

Staff told us they were supported by their managers and received training that allowed them to safely carry out their role. Staff had their competencies to administer medicines assessed. Staff could describe how they would follow up urgent queries and access urgent medicines.

Policies and procedures for the safe management of medicines were in place. Staff received regular training and competency assessments on the administration of medicines to ensure they were safely administering medicines. The provider had effective audits in place to check medicines had been administered as and when prescribed.