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Inspection carried out on 24 September 2019

During a routine inspection

About the service

Derriford House is a residential care home providing personal care to 30 people at the time of the inspection. The service can support up to 34 older people who may be living with the early stages of dementia.

People’s experience of using this service and what we found

People received care and support that was safe. The provider had improved how they managed people’s medicines in response to recommendations we made in our last report. The provider protected people from risks, including the risk of abuse or avoidable harm, and risks associated with the building and equipment used. There were effective recruitment processes in place to make sure staff employed were suitable to work with people in their homes. The provider actively promoted safety in the home, including processes to control the risk of infection.

People received care and support that was effective and based on thorough, detailed assessments and computer-based care plans. Staff received training and support to deliver effective care according to people’s needs and preferences. The provider worked with other agencies to deliver consistent and effective care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were caring and kind relationships between people and their care workers and other staff. These were based on compassion and understanding of people’s needs. The provider worked to respect and promote people’s privacy, dignity and independence, and encouraged people to be involved in their care.

People received care and support which met their needs and reflected their preferences. The provider followed best practice guidance with respect to meeting people’s communication needs. People had access to a range of relevant and meaningful activities.

The service was well led. There was focus on meeting people’s individual needs in a comfortable, home-like environment. The provider worked in cooperation with others and worked to continuously improve the service people received. This was supported by effective management, governance and quality systems.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 31 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 11 January 2017

During a routine inspection

Derriford House is a privately run care home registered to provide accommodation for up to 34 older people. At the time of our inspection there were 34 people living in the home, although one was in hospital.

The inspection was unannounced and was carried out on 11 and 12 January 2017.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People and their families told us they felt the home was safe. However, although medicines were generally managed safely, staff administering medicines did not always follow best practice guidance. We have recommended that the owners seek advice and guidance on adopting the latest best practice guidance in respect of managing medicines.

Staff knew the people they supported and were able to explain the risks relating to them and the action they would take to help reduce the risks from occurring. However, the supporting documentation was not always detailed and personalised to reflect staff’s understanding. We raised our concerns with the registered manager and by the second day of our inspection they had taken action to ensure people’s risk assessments were personalised and reflected people’s needs.

Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the owners safeguarding policy and explained the action they would take if they identified any concerns.

Staff sought people’s consent before providing care and understood the need to follow legislation designed to protect people’s rights. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to remain as independent as possible and maintain relationships that were important to them.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.

People and when appropriate their families were involved in discussions about their care planning, which reflected their assessed needs.

There was an opportunity for people and their families to become involved in developing the service. They were encouraged to provide feedback on the service provided both informally and through ‘resident meetings’ and an annual questionnaire. They were also supported to raise complaints should they wish to.

People’s families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role. The owners was fully engaged in running the home and provided regular support to the registered manager. Staff were aware of the owners vision and values, how they related to their work and spoke positively about the culture and management of the home.

There were systems in place to monitor quality and safety of the home and care provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

Inspection carried out on 5 December 2013

During a routine inspection

During our visit we saw that people were being treated with dignity and respect and people's independence was encouraged. People were spoken to in a respectful way. People we spoke with told us that the staff were easy to talk to, approachable and helpful, and that their privacy was respected whilst they were supported to maintain their independence. One person told us "I think the staff are lovely here - I can't complain. They are very good and if I was not happy I would tell them".

People chose how to occupy themselves in the service. We observed that people were spending time in the communal areas watching television and reading. During our inspection we observed people spending time in their bedrooms watching television and spending time with their family writing Christmas cards. We observed staff spending the majority of their time with people who used the service. They frequently checked on them to ensure they were alright when spending time on their own.

We saw staff supporting people to make their own choices about what they had for lunch and what activities they took part in. Staff knew exactly how each person communicated which meant people's wishes were understood and respected. One person told us "It is very nice here and I am very happy. They look after us well, they know what is important to us and what we like to do".

A member of staff told us "it is very nice here and I am very happy - I love my job. I love being here and the difference we make".

Inspection carried out on 2 January 2013

During a routine inspection

At the time of our inspection 33 people were living in this home.

People told us they enjoyed living in the home and were positive about the care staff and about the food the home provided.

The staff respected people�s choices about their care. When people were unable to make decisions the staff worked with others to assess what was in the person�s best interest.

We saw that peoples care was well planned and delivered. The home responded to people�s changing needs.

People had a good choice of food, which was provided according to their individual needs and preferences.

Cleanliness and hygiene was well managed. Appropriate plans were in place to manage potential outbreaks of infectious diseases.

The service recruited suitable staff by well planned recruitment and induction processes. People in the home were happy with the staff and the more experienced staff felt that new workers were suitable for the duties expected of them.

The service had a complaints policy in place that is accessible to people in the home and to their visitors.

Reports under our old system of regulation (including those from before CQC was created)