Background to this inspection
Updated
24 March 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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.
The inspection took place on 21 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides a small respite service and we needed to be sure that someone would be in.
The service was inspected by one inspector. We spoke with the provider and one person who used the service at the time of the inspection. We contacted two relatives by telephone after the inspection to gather their views about the service. We spoke with local authority contracts and safeguarding officers. They told us that they were not aware of any concerns about the service, and there were no ongoing safeguarding investigations. We read testimonials and comments on the provider’s website.
We checked records, including the training records of the provider, and policies and procedures relating to the safe running of the service. We checked the care records of three people.
We looked at the premises including the areas of the provider’s home, sometimes used by people who used the service. We observed the provider interacting with a person who used the service and spent time with them both.
Prior to carrying out the inspection, we reviewed all the information we held about the home. The provider completed a provider information return (PIR). A PIR is a form which asks the provider to give some key information about their service; how it is addressing the five questions and what improvements they plan to make. We also looked at notifications submitted by the provider in line with legal requirements.
Updated
24 March 2016
The inspection took place on 21 January 2016 and was announced. We gave the provider short notice as this was a small respite service and we wanted to make sure people were in. The service was previously inspected in April 2014 and met all of the regulations that we inspected at that time.
Darmel Respite is a small respite service, caring for one person at a time who may have a physical disability or progressive illness. The registered provider manages the service and is the only member of staff.
A Disclosure and Barring Service (DBS) application had been completed prior to the provider commencing operation of the service. The DBS supports the safe employment of staff caring for vulnerable people by carrying out criminal record checks and ensuring they are not barred from caring for vulnerable people.
A detailed pre admission assessment was carried out to ensure that the provider was aware of all safety requirements and equipment that would need to be in place to ensure the safety of people who used the service. Individual risk assessments were carried out and there were resources for example, skin integrity or nutrition assessments, to use should any further risks be identified during their stay.
A person who used the service and their families told us that the provider was able to meet the needs of people staying at Darmel respite very well. The provider had contingency plans in place to enable additional staff to support her should the need arise.
There were safe procedures in place for the storage and administration of medicines. People were supported to maintain their independence and manage their own medicines where this was appropriate.
The provider had carried out a range to training to enable her to care for people safely, including moving and handling, and the safe management of medicines. She had also carried out self-directed learning to find out more about particular health conditions. People and their relatives told us that the provider was highly skilled and very effective in her role as a “carer”.
People were consulted about their care, and before each visit to the service, the provider visited people to ensure that they consented to their stay and the care and support that would be provided. We saw that people had signed to confirm their agreement.
People were supported to eat and drink and any special dietary considerations were catered for. The provider had previous experience as a cook, and was happy to provide meals based on the preferences of people who used the service. She had knowledge of special dietary requirements and foods to avoid in certain health conditions.
There was access to healthcare services if required, but this was not usually necessary during a respite stay. The provider escorted people to pre-arranged hospital appointments, and ensured that she had all of the necessary up to date information regarding health needs. Care plans were in place and contained the required amount of detail.
The service consisted of a purpose built unit which was attached to the provider’s home. People could choose to remain in their own accommodation, or join the provider and their family in the family home. The building was wheelchair accessible and people were able to use an alternative entrance to the family for their privacy. The people we spoke to liked the fact that they were able to be included in the activities of the family if they chose to do so, and the kitchen was a favourite place for people to sit and talk or carry out activities. There was an en suite wet room with ample space to allow people to be supported. The provider was aware of the importance of maintaining dignity, and was very sensitive and discreet in her communication about this.
We received very positive feedback about the service from people and their relatives. They all told us that the provider was very kind and had a natural gift for caring. They particularly liked the one to one attention they received from the provider and her ability to put people at ease and to make them feel at home. People were included in all aspects of their care and the provider took pictures of the service and provided information to people and their families before they used the service. People were given choices about all aspects of their stay and the provider went out of her way to make the transition between home and the service as seamless as possible.
The provider regularly sought the views of people who used the service and their families. There was a satisfaction survey on the website which people were encouraged to complete, and the provider was introducing paper versions of this to ensure they were accessible to everyone who used the service. There were no plans to expand the service as the provider was keen to ensure it remained as homely and responsive as possible, but told us that she was always keen to learn new skills to improve upon any aspect of the service. People we spoke to told us they could not think of anything that could be improved and said they were very happy with the quality of the service provided.
People who used the service had capacity, and the provider was aware of the requirements of the Mental Capacity Act 2005 and appropriate training had been completed.