We carried out a review of the data available to us about Desmond House Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Desmond House Limited, you can give feedback on this service.
Desmond House Limited is a residential care home providing personal care to up to 18 people. The service provides support to people with mental health needs, learning disabilities and autism. At the time of our inspection 16 people with mental health needs were using the service.
People’s experience of using this service and what we found
At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right care
The provider had made improvements since the last inspection. Infection, prevention, and control was well managed. Staff were trained and understood their responsibilities for maintaining high standards of cleanliness. Staff managed medicines consistently and safely. Staff were competent and trained in the administration of medication. Effective safeguarding systems were in place. Safeguarding concerns were managed consistently and promptly. All staff had an awareness and understanding of abuse and felt comfortable with raising concerns about their own or other people’s safety.
Right Support
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 was enough competent staff on duty to care for people safely. People were supported to remain safe. Risk assessments were person centred and creative in relation to people’s safety. Staff were aware of people’s risks and how to manage them. Staff understood their responsibilities to raise concerns and report accidents and incidents. Lessons were learned and communicated to staff.
Right Culture
The service had a positive culture that was person centred and empowering. Interactions between staff and people was personalised and relaxed. The provider had clear governance systems in place that identified and managed risk through audits and action plans. These were used to monitor the services performance and drive improvements.
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 requires improvement (published 4 February 2020). At our last inspection we recommended the provider made improvements in infection, prevention and control and quality monitoring. At this inspection we found the provider had made improvements in these areas.
Why we inspected
We carried out an unannounced inspection of this service on 18 December 2019 and the 09 January 2020. We undertook this focused inspection to confirm the improvements had been made. This report only covers our findings in relation to the Key Questions safe and well-led which contain those improvements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Desmond House Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
• The service sent letters or emails to visitors prior to arranging a suitable time to visit. These included a code of conduct to outline the expectations during visits to ensure people’s safety and reduce the risk of infection transmission. Visitors had access to alcohol hand gel and face masks during their visits.
• Staff took time to speak with people, show them how to put on and take off their personal protective equipment (PPE) and explain the risks should they choose not to wear PPE. Staff were wearing PPE at all times to reduce the risk of transmitting the infection.
• The staff worked with people and their relatives to ensure they were aware of isolation procedures should they be needed. Relatives were encouraged to attend garden visits and use video calls and phone calls to support people’s well-being.
Further information is in the detailed findings below.
Desmond House Limited is a care home providing personal care and accommodation for up to 19 people with mental health needs in one adapted building. At the time of our inspection 17 people were using the service.
Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Quality monitoring of the service required improvement to ensure it was effective. The current systems in place had not always highlighted areas for improvement, or where they did action plans were not always recorded effectively. Management systems need to work better to ensure safety and quality for people.
We have made recommendations in the safe and well-led section of this report about improving systems to ensure timely quality monitoring is undertaken.
We received positive views from people using the service, people told us they were well supported by the staff and manager. People, their relatives and staff told us they were confident in the management of the service and good personal and professional relationships existed.
People were protected from avoidable harm and abuse by trained, knowledgeable staff. People were supported by a small group of staff who had a positive approach to risk management and helped people to safely make the most of opportunities and activities.
Staff supported people in a kind and caring way that took account of their individual needs and preferences. People were supported to express their views and be involved in making decisions about their care and support.
Recruitment, induction and ongoing processes helped ensure only suitable staff were employed and that they had the required skills and knowledge. Staff were supported by the registered manager through supervision and team meetings.
People received regular and on-going health checks and support to attend appointments. They were supported to eat and drink enough to meet their needs and to make informed choices about what they ate.
The service was responsive to people's needs and staff listened to what they said. Staff were prompt to raise issues about people's health and people were referred to health professionals when needed.
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 8 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At this inspection, we found the service remained good.
People were supported by staff who understood the importance of protecting them from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities. Staff, who had been recruited safely, were provided in enough numbers to meet the needs of the people who used the service.
People were provided with a wholesome and nutritionally balanced diet which was of their choosing. Staff were provided with training in how to meet people’s needs and were supported to gain further qualifications. People were supported to access healthcare professionals when needed and were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.
Staff had a good understanding of people’s needs and were kind and caring. They understood the importance of respecting people’s dignity and upholding their right to privacy and choice.
People were supported to participate in activities, these included in house pursuits and involvement with the local and wider community. Complaints were investigated and resolved wherever possible to the complainant’s satisfaction. People received care which was tailored to their needs and person-centred.
People who used the service, and those who had an interest in their welfare and wellbeing, were asked for their views about how the service was run. Regular audits were carried out to ensure the service was safe and well run, however, these could be developed further this was discussed with the registered manager.
Further information is in the detailed findings below.
Desmond House is located in the north of Hull and close to local amenities. The accommodation consists of two adjacent semi-detached houses linked together and has two floors which are accessed via stairs. There are sufficient communal areas including two lounges and a dining room.
The home offers support for up to 19 adults who have mental health needs. There were 17 people residing at the service at the time of the inspection.
The service was last inspected 27 March 2013 and was found to be compliant with the regulations inspected at that time.
People were cared for by staff who had received training and understood the need to safeguard them from harm. Staff could recognise the signs of abuse and knew who to report this to; this meant people who used the service were protected from harm.
People’s medicines were handled and stored safely and staff received safe handling of medicines training.
Staff were appropriately trained and provided in enough numbers to meet the needs of the people who used the service. However, some training may need more regular updating; we have made a recommendation about this. Staff had been recruited safely and this meant people were not exposed to staff who had been barred from working with vulnerable adults.
People were provided with a wholesome and nutritious diet which was monitored by staff to ensure people were leading a healthy lifestyle.
Staff had received training in how to ensure people’s human right were protected so they could make informed decisions about their chosen lifestyle. People were supported to make informed choices and decisions which were in their best interest. Systems were in place to make sure people were protected and did not take any unnecessary risks. Staff had a good understanding of the principles of the Mental Capacity Act 2005 and the use of Deprivation of Liberty Safeguards.
People had access to health care professionals when needed, for example their GPs, and were supported by staff to attend hospital appointments.
People were involved with their care plans and could have a say about how their care was delivered. People who used the service had good, relaxed and friendly relationships with the staff. Staff understood people’s needs and how they should be supported to lead a lifestyle of their own choosing. People were supported to maintain friendships outside of the service and visitors were made welcome.
People were supported by staff to undertake activities both inside and outside of the service and were enabled to lead an independent life. People could make complaints and they were confident these would be listened to and acted on.
People who used the service were asked for their opinion about how the service was run. Other stakeholders who had an interest in the welfare and wellbeing of the people who used the service were also asked for their opinions; this included relatives and health care professionals. The registered manager undertook audits which ensured the service was safe and well run.
People told us, 'I love my bedroom", "I get up when I want to and go out everyday" and "We talk about the menu at our meetings."
People who used the service told us they were happy with the level of care and support they received and commented, "The staff are very nice and help me when I need them to" and "I like it here."
People told us they had their views and concerns listened to and told us, "Yes staff listen", "I've never had any problems and I am very happy here" and "If there is anything wrong then the manager will sort it."
They told us that choice was offered and consultation took place particularly regarding the menu, 'The food is very good and we talk about what we like.'
People who used the service told us they were happy with the level of care and support they received. They also told us that they were involved in the development of their individual personal profile, which gave details about their likes, dislikes and preferences.
People who used the service told us, 'The staff are nice', 'I have my own money and take care of it myself' and 'Yes, so far I feel safe.'
People told us that they liked living at Desmond House and commented, 'I like living here and I have my own room' and 'It is always clean and tidy.'
People who used the service told us there were enough staff on duty and that they were polite and courteous.
People told us their views and concerns were listened to.