We inspected the service on 10 March 2016 and the visit was unannounced. Damascus House provides accommodation for up to 12 people who have a learning disability. At the time of our inspection 12 people were using the service. The service is on two floors accessible by stairs. There are two lounges and dining areas for people to choose from. There is also access to a large garden area for people to use should they choose to.
It is a requirement that the home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 service had a registered manager in place at the time of our inspection.
People told us that they felt safe living at the home and staff knew how to protect them from harm and abuse. Accidents and incidents had been investigated and analysed to try and prevent them from reoccurring. Risks to people had been assessed and the regular checking of equipment within the home had taken place. There were plans available to staff on how to keep people safe during emergencies.
People were supported to keep safe by the provider having adequate staffing numbers available at all times. Staff were checked prior to working for the provider to make sure that they were suitable for their role. This helped the provider to make safer recruitment decisions.
People received their medicines as prescribed by their GP. The provider had made arrangements for the safe storage and administration of medicines. The registered manager told us that they would review some of their guidelines when considering the use of as and when needed medicines. This was because the current practice of staff was not always documented.
People received effective support from staff that had the rights skills and knowledge. Staff had undertaken regular training and there were plans to enhance their skills further. For example, training in fire safety was due to occur within the next month.
People received support from staff who knew the requirements of their role. Staff had received an induction when they had started to work at the service and met regularly with the registered manager.
Staff understood the Mental Capacity Act (2005) and could describe the importance of gaining people’s consent prior to carrying out care and support with them. People were being supported to make their own decisions where possible and their understanding of specific decisions had been assessed.
People had enough to eat and drink and were being supported to maintain a healthy lifestyle. People had been involved in planning the menu and the food offered was based on their preferences.
People had access to healthcare services when they needed to. Information about people was available to healthcare staff in order to support people appropriately when, for example, they needed a hospital admission.
People were supported by staff who cared. Friendly relationships between people and staff had developed which people spoke positively about. People’s dignity and privacy had been respected and their sensitive and private data was being kept secure.
People’s preferences and interests were known by the staff team. Staff had taken care to make sure that care and support offered was in line with these. People took part in activities that they enjoyed and that were important to them.
People and their relatives had contributed to and been involved in planning and reviewing the care and support provided. People’s support plans were individual to each person and in such detail that staff had thorough information about how to provide good support. People’s independence was being encouraged and relationships that were important to them had been maintained.
People did not have information about advocacy services that they might have needed to in order to support them to speak up about things that were important to them. The registered manager told us that they would look at ways to improve this.
People and their relatives knew how to make a complaint. The information was presented in a way that helped people to understand the process. Feedback about the service had been sought through meetings people had been involved in.
The service was well-led and staff and social care professionals confirmed this. The provider had looked at ways to improve the service for the people it supported.
Staff knew about their roles and responsibilities. This included raising concerns about their colleagues should they have needed to. The registered manager gave feedback to staff about the standards of their work.
The registered manager was spoken highly of and largely understood the requirements of their role. They needed to tell CQC when a person’s deprivation of their liberty had been authorised by the local authority.