Archived: Dryad Spinney

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found '

Is the service safe?

Action had been taken to help ensure that people who use the service were protected against the risk of unlawful or excessive control or restraint. We saw that support plans included guidance on how staff should support individuals whose behaviour may sometimes be challenging. Staff demonstrated their understanding of using non-confrontational approaches and knowledge of how different individuals may communicate through their behaviours. They were aware that physical intervention should only be used as a last resort and that the type of restraint should be the least restrictive and for the minimum amount of time.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. The manager understood when an application should be made and how to submit one. The manager and operations manager were aware of recent changes to the legislation.

Is the service effective?

While there were systems for identifying, assessing and managing risks relating to the health, welfare and safety of people who use the service and others, these had not always been effective. People had not always been cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to supporting workers, and assessing and monitoring the quality of service provision.

Other aspects of the service were effective. For example, we saw how personalised care and support had enabled one person to integrate more fully with the day to day life of the home. They confirmed that they were getting the support that had been planned with them and said they were 'Doing OK'.

Is the service caring?

People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Activity plans and schedules were different for each individual and were flexible to accommodate changes in the choices they had made.

We observed staff supporting people in ways that upheld their dignity and promoted their independence and community involvement. Staff we spoke with demonstrated their understanding of the needs of people who use the service and interacted positively with them.

There was a relaxed atmosphere in the home and we saw that staff communicated well with the people who use the service and promoted an inclusive, supportive environment.

Is the service responsive?

The service is responsive to people's changing needs. Monthly meetings took place between individuals and their key workers. We saw that the service was continuously developing and updating strategies for supporting people, based on consultation and observation of people's changing needs.

We saw that people's health needs were monitored and referred to health and social care professionals appropriately. For example, staff had identified changes in a person's behaviour, mood and sleep pattern and had referred them to a GP.

The provider and manager had liaised with other agencies in an open and transparent manner, to request their professional assistance in supporting a person who was challenging the service.

Is the service well led?

Regular audits of the quality and safety of the service took place and were recorded. These included checks carried out by the manager and others performed through the organisation's quality assurance teams. There were risk assessments for each person using the service and for matters relating to the home environment, such as an up to date fire risk assessment. Procedures were in place for reporting accidents and incidents and there was a system to monitor and respond to any concerns or complaints about the service.

A staff member said 'The manager is doing ever so well, sorting out many things'. They said they felt well supported, for example through staff meetings and the manager's approach: 'The manager's door is open if you have any concerns'. Another support worker told us they felt the manager listened to them and that it was good that 'Staff were having an impact' on how the service was delivered.

Another member of staff told us they welcomed being given more responsibility, through the manager's approach. The manager had also introduced regular meetings of the senior support staff. This indicated there were clear lines of accountability within the service.

Care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. Staff we spoke with demonstrated a clear understanding of people's support and risk management plans. People were provided with a choice of suitable and nutritious food and drink. Healthy eating was encouraged and records were kept of each individual's nutritional intake. The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. Appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.