Dean Park

We found the following examples of good practice:

Safe arrangements were in place for professionals visiting the service. This included a confirmed negative lateral flow device test result, proof of vaccination against COVID-19, temperature checks, hand sanitisation and wearing personal protective equipment (PPE).

The service was clean and fresh, staff carried out a regular cleaning schedule. Regular infection control audits took place and actions had been followed up when required. An additional cleaning schedule had been introduced to ensure robust measures to reduce infection risks, including additional tasks such as cleaning of any regular touchpoint surfaces.

The provider had robust systems to ensure safe admissions, including only allowing new admissions after a confirmed negative result of the Covid-19 test. The provider had also assessed the environment, with consideration given where to allocate people should they need to isolate.

Staff had received training on infection prevention and control guidance. This included updates on the use of PPE and how to put it on, take it off and dispose safely. Staff's competency around infection control and PPE was checked regularly to prevent staff complacency. There were several designated areas for donning and doffing PPE. There was signage all around the service on donning and doffing PPE and handwashing.

The provider ensured there was a sufficient stock of personal protective equipment (PPE) and the vetted supplier ensured it complied with the quality standards.

The provider participated in the Covid-19 regular testing programme for both people and staff.

There was a comprehensive contingency plan of what to do in case of an outbreak. The management team completed risk assessments to assess and mitigate risks in relation to COVID-19. Managers were supported by a regional quality and assurance manager who regularly supported quality and assurance audits on the service.

This unannounced inspection took place on 14 November 2018. At our last inspection in May 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

Dean Park is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Dean Park is one of two care homes located in two adjacent semi-detached houses run by Optimal Care. It provides care and support for up to five people with learning disabilities. There were four people using the service at the time of the inspection.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

People continued to receive safe care and there were enough staff to meet people’s needs. Staff had been suitably recruited to ensure they were able to work with vulnerable people. People had risk assessments in place to enable them to be as independent as possible. Staff were able to recognise abuse and knew how to report it appropriately.

The service was very effective. Staff received appropriate support to carry out their roles on a day-to-day basis through structured supervisions and appraisals. Staff were well-trained and the service aimed to facilitate their further professional development. The service worked well in cooperation with other professionals to ensure people’s needs were met safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems of the service supported this practice. People had access to health care professionals and staff ensured people led healthier lives.

The service remained caring. Staff were considerate, kind and helpful to people. Their knowledge of the individual choices and preferences of people enabled them to provide people with relevant care and support. People were involved in the planning and review of their care and people’s family members continued to play an important role in these processes as well. People's privacy and dignity were maintained at all times.

The service was responsive to people’s needs and wishes. People and their relatives told us that staff went over and above the call of duty. People and their relatives also said this made a profound difference to their lives. The management appreciated and acted on people's and relatives’ opinions on the service.

The service continued to be well-led. People and staff had confidence in the manager as their leader and were complimentary about the positive culture within the service. There were systems and processes in place to help monitor the quality of the care people received.

Dean Park provides care and support for up to five people with learning disabilities. The home is situated in a residential area of Swindon, adjacent to another service run by the same provider. The two services share a garden and a minibus. At the time of this inspection there were five people living on the premises.

There was a registered manager in post; however, they were not available on the day of the inspection. Instead, the deputy manager provided us with the information comprising a large portion of this report. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The testing of fire equipment had not always been carried out in accordance with the provider’s policy. There were gaps in weekly fire alarm and three monthly emergency light checks. However, the manager took immediate action to put these checks in place.

People and their relatives told us they felt safe. Staff understood their responsibilities in keeping people safe from harm, and knew how to report any concerns. Relatives told us there were enough staff to support people living at the home, and that staff had the right level of skills and experience. Medicines were safely stored and administered by staff who had been trained and assessed as competent.

Staff undertook training which was focused on helping them to understand the needs of the people they were supporting. People were involved in making decisions about the way in which their care and support was provided. Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day-to-day routines. People's health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people's care. People were supported to maintain healthy nutrition suited to their health condition, which was constantly monitored by staff.

The service was caring and people experienced care that was compassionate. Staff treated people as individuals and encouraged them to do as much for themselves as possible. People's privacy and dignity were respected. People were supported to have a social life and to go out into the community and go on holidays.

People were involved in shaping the support they were going to receive. They worked closely with their keyworkers to make plans for future activities and goals they wished to achieve. There was a complaints procedure in place and relatives told us that they were aware of the process and the service was responsive to issues of concern when expressed.

The home was decorated in a manner that reflected the needs, personalities and preferences of each person.

Accidents had been investigated thoroughly by the registered manager. The registered manager reviewed the logs to identify any regular patterns of incidents/accidents and to minimise the risk of their reoccurrence.

Relatives and staff expressed confidence in the registered manager and the provider and felt they were listened to when they gave feedback. There was an open culture within the home and people felt able to express their views and opinions. Quality audits were completed and used by the registered manager as a basis for assessing the overall quality of the home.

People were treated with respect and dignity by the staff. People we spoke with told us that they felt safe living at the home. One person said: 'I do. I feel safe. I know I've people I can depend on.'

The service followed the local authority safeguarding procedure and staff understood how to safeguard the people they supported. Systems were in place to make sure that managers and staff learned from events such as accidents and incidents. This reduced the risks to people and helped the service to improve.

The home had suitable policies and procedures and training in place in relation to safeguarding, the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). DoLS protect the human rights of adults who live in a registered care home or a hospital, lack capacity to consent to arrangements proposed for their care or treatment and for whom such arrangements amount to a deprivation of liberty. DoLS are not considered when a person is detained under the Mental Health Act 1983 (as amended by the Mental Health Act 2007). No authorisations had needed to be in place at the time of our visit. Relevant staff had been trained to understand when an application should be made, and knew how to submit one.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs. One person told us: 'I have a say in my care plan. I can change it.'

Is the service caring?

People were supported by caring staff. We saw that support workers explained care and encouraged people. One person told us 'You couldn't get any better care.' Another person said that 'It's lovely living here.'

People who used the service and their relatives and representatives who were involved with the service completed an annual satisfaction survey. Issues or concerns raised were addressed by the provider.

People's preferences, interests, aspirations and diverse needs had been recorded. Care and support had been provided in accordance with people's wishes.

Is the service responsive?

People enjoyed a range of activities in and outside the service regularly. Some people accessed the community independently. The service supported people to be involved with their local community.

People were aware how to make a complaint, with support if necessary. People could therefore be assured that appropriate action would be taken.

Is the service well-led?

The service worked in collaboration with other agencies and services so that people received effective care.

The service had an effective quality assurance system. We saw records which showed that the manager addressed any issues. As a result the quality of the service improved.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of their roles. This helped to ensure that people received a good quality service.

People were supported to be fully involved in the planning and reviewing of their care and support. People's independence was promoted and supported.

The home had safe procedures in place to administer medication and the staff were appropriately trained to carry out this responsibility.

The home ensured that there were sufficient staffing provided on duty to meet people's needs.

There were safe procedures in place for the recruitment of staff. Appropriate checks were completed before people were appointed. People who lived in the home were involved in the recruitment process for new staff.

People told us they received the required support to undertake activities in the community and were encouraged and supported to maintain their independence. People told us they were involved in the planning and reviewing of their care and support and enjoyed having a key-worker to work with. We were told Dean Park was a safe place to live.

We found that people's care and support needs were well met and that detailed and up to date care plans were in place.

We found that the home correctly stored and administered medication and that appropriate training was provided for staff before they undertook this responsibility.

The home had the required recruitment procedures and pre-employment checks in place for staff.