Archived: Dorset Residential Homes - Kirtleton Avenue

Is the service safe?

The service was compliant with the provisions of The Mental Capacity Act 2005 and had acted to ensure people's rights were protected, taking account of the latest legal judgements and guidance. People using the service had complex needs associated with learning disabilities and were unable give appropriate consent to decisions about where they lived and their care and treatment. The provider consulted with others who knew the person to help determine how best to care for people safely. Staff demonstrated an awareness of working with appropriate consent, how to identify signs of possible abuse and how to report this to prevent or reduce harm.

Is the service effective?

The care plans were holistic and detailed and personalised. The service used detailed risk assessments to help reduce or prevent the risk of harm and staff were supported to understand people and how their situation and condition might affect them. Care and support for people was planned on a daily basis to ensure staff understood their role and carried out their duties effectively.

Is the service caring?

Staff were helped to build supportive relationships with people. We saw they treated people with respect and consideration. One member of staff told us, 'the person is visually impaired so they have to get used to new voices sometimes and we have to be aware of that."

Is the service responsive?

Care plans guided staff about what care and support to provide and how to monitor changes and health conditions specific to each person. We saw the home worked collaboratively with healthcare professionals to ensure people had access to preventative healthcare, such as opticians and chiropody and with nurses and GPs to ensure illness was detected and treated.

Is the service well led?

At the last inspection we found that the provider had not met certain standards and lacked effective systems for taking action. At this inspection we found there was improvement in all the standards we looked at. The service was in the process of confirming the registered manager however they had been working with the service and the senior managers of the provider organisation for six months. We found the care plans had all been updated and staff received regular supervision and support and there were opportunities for professional development. There was clear guidance for staff about how to care for people and how to maintain a safe environment. This meant that people were cared for by staff that were suitably qualified and supported. There were well organised records and systems which helped to ensure the service was monitored effectively.

The people living at Kirtleton Avenue had complex needs and communication difficulties and so we were not able to ask them about life in the home. Staff were seen to talk to people in a friendly and caring manner.

People were supported to make choices about their day to day lives, but their needs were not all assessed and care was not always delivered in line with individual care plans.

Staff knew how to identify abuse but there was an emphasis on raising concerns within the organisation as opposed to with other agencies. This meant there was a risk that safeguarding alerts had been delayed.

People were cared for by staff who were not being supported to deliver care and treatment safely and to an appropriate standard. Staff were not receiving regular supervision to support their professional development and discuss practice issues. One care worker told us, 'Supervision has lapsed really.'

The home did not have effective systems in place to monitor the quality of the service or to assess and manage risks to people living in the home.

Records were not accurate or kept up to date.

We found improvements in both areas of concern. Changes had been made and plans were in place to make further improvements.

We spoke with two members of staff and the registered manager.

Staff told us they felt more change was needed but that changes were happening and that senior management from the provider organisation were more actively involved.

Care documentation gave staff clear guidance regarding the delivery of care, and each individual's care plans reflected their personal preferences and wishes.

There was a calm and relaxed atmosphere in the home and people were at ease in the company of the staff supporting them. The staff were friendly and polite in their approach and interacted confidently with people. The staff that we spoke with were very knowledgeable about the people they cared for, and we observed that people were effectively supported to engage in activities that were meaningful to them. For some people this involved sensory activities, and for others it included activities in the local community.

There were systems in place to ensure that the health, safety and well being of people was monitored, and where changes to people's care or the environment were required, these were swiftly addressed. Records were kept under review, and risk assessments were in place to minimise the risks and protect people in this home.