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Inspection Summary


Overall summary & rating

Good

Updated 18 November 2016

This was an unannounced inspection carried out on 1 November 2016.

Delph House can provide accommodation and personal care for 22 older people. It can also accommodate people who have sensory needs, who have a physical disability or who live with dementia. There were 17 people living in the service at the time of our inspection most of whom were older people who lived with dementia.

The service was operated by a company which acted as the registered provider. The company was formed by two directors. One of them was the managing director who was personally involved in overseeing the running of the service. They regularly called to the service to see how things were going. There was also a registered manager who 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. In this report when we speak about both the directors of the company and the registered manager we refer to them as being, ‘the registered persons’.

At our inspection on 2 and 3 November 2015 there were three breaches of legal requirements. We found that some people had not been consistently supported to eat and drink enough to stay well. In addition, we found that some people had not received all of the care and reassurance they needed when they became distressed. We also found that quality checks had not been robustly completed and this had led to shortfalls in the service not being quickly resolved. After the inspection the registered persons wrote to us to say what actions they intended to take to address the problems in question. They said that all of the necessary improvements would be completed by 15 December 2015. At the present inspection we found that the necessary improvements had been made to ensure that the three legal requirements had been met. However, we noted that some quality checks still needed to be strengthened further. This was necessary to better enable the registered persons to quickly resolve some remaining problems with how the service was run.

At this inspection we also found that staff knew how to respond to any concerns that might arise so that people were kept safe from abuse, including financial mistreatment. Medicines were safely managed but some additional steps needed to be taken to reduce the risk of accidents. There were enough staff on duty to provide people with the care they needed but a background check had not been completed before a new member of staff had been appointed.

Staff had been provided with support and guidance and they knew how to care for people in the right way. Most people enjoyed their meals but some of them wanted to have more choice. Staff had ensured that people had received all of the healthcare assistance they needed.

Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had taken the necessary steps to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. Although staff respected people's privacy and promoted their dignity this was not fully reflected in the arrangements used when people saw the hairdresser. Confidential information was kept private.

People received all of the practical assistance they needed and had been encouraged to pursue their hobbies and interests. There was a system for quickly and fairly resolving complaints.

People had been invited to suggest improvements to their home and their views had been acted upon. The service was run in an open and inclusive way, good team work was promoted and staff were supported to speak out if they had any concerns. People had benefited from staff acting upon good practice guidance.

Inspection areas

Safe

Good

Updated 18 November 2016

The service was safe.

Staff knew how to keep people safe from the risk of abuse including financial mistreatment.

Medicines were managed safely.

Some additional measures were needed to fully protect people from the risk of accidents.

There were enough staff on duty but the recruitment procedure needed to be strengthened.

Effective

Good

Updated 18 November 2016

The service was effective.

Staff had received training and guidance to enable them to support people in the right way.

People had been assisted to eat and drink but more needed to be done to ensure that people could choose what meals they wanted to have.

People had been supported to receive all the healthcare attention they needed.

People were helped to make decisions for themselves. When this was not possible legal safeguards were followed to ensure that decisions were made in people’s best interests.

Caring

Good

Updated 18 November 2016

The service was caring.

Staff were caring, kind and compassionate.

Although staff recognised the importance of promoting people’s privacy and dignity this commitment was not fully reflected in the arrangements made when people saw the hairdresser.

Confidential information was kept private.

Responsive

Good

Updated 18 November 2016

The service was responsive.

People had been consulted about the care they wanted to receive.

Staff had provided people with all the care they needed including people who could become distressed.

People were helped to pursue their hobbies and interests.

There was a system to quickly and fairly resolve complaints.

Well-led

Requires improvement

Updated 18 November 2016

The service was not consistently well led.

Quality checks had not always identified and quickly resolved problems in the running of the service.

People and their relatives had been asked for their opinions of the service so that their views could be taken into account.

There was good team work and staff had been encouraged to speak out if they had any concerns.

People had benefited from staff acting upon good practice guidance.