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Inspection carried out on 17 July 2017

During a routine inspection

Delbrook House is a small service which provides personal care and support for up to six people who are living with low level needs associated with learning difficulties. The building consists of two adjoining houses and rooms are spacious with high ceilings. Bedrooms are for single occupancy and each person has their own en-suite facilities of a shower, toilet and sink or bath/shower rooms identified for their sole use. Communal rooms consist of a spacious sitting room with a dining area at one end and another quiet room.

At the last inspection, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’ overall, although we judged the responsive domain ‘Outstanding’.

We found people were supported to live their lives and access community facilities in such a way that it had impacted very positively on their emotional and social wellbeing. They had an excellent quality of life and attended functions, events that interested them and had memorable holidays funded by the provider. Staff supported people to nurture family relationships and friendships, and assisted them with important lifestyle decisions.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were complimentary about the staff and told us they looked after them well and respected their privacy and dignity. We saw people had weekly plans of activities in the service and in the community.

Assessments and care plans were very person-centred and evidenced that people had been involved as much as possible and included in decisions about their life. The care plans were detailed and gave very good information to staff in how to support people in the way they preferred. The local authority contracts and commissioning team had recently visited the service and told us they were ‘very impressed’ with the care plans and the level of detail included in them.

We found there were sufficient members of staff on duty to meet people’s needs. Staff had been recruited safely with employment checks carried out before they started work. Staff had access to a range of training and received supervision and support on a daily basis. Those staff spoken with told us they felt confident supporting people and meeting their assessed needs.

Staff had received training in how to keep people safe from the risk of harm and abuse; it was clear they knew what to do if they had concerns or if they witnessed abuse or poor practice. Staff completed risk assessments to help minimise risk whilst still enabling people to have control over their lives.

Medication was well managed and people received their medicines as prescribed.

The environment was clean and tidy. Equipment used in the service was maintained and any repairs completed in a timely way.

People’s health and nutritional needs were met. Staff supported people to attend appointments with health professionals in the community. The menus provided people with a well-balanced and nutritious diet, whilst still allowing for treats.

There was a complaints procedure in an easy read format and people told us they felt able to raise concerns when needed and these would be addressed.

The registered manager was very passionate about providing an inclusive atmosphere for people who used the service. They encouraged people to express their views on a daily basis about the running of the service.

Further information is in the detailed findings below.

Inspection carried out on 24 August 2015

During a routine inspection

Delbrook House is registered with the Care Quality Commission [CQC] to provide care and accommodation for six adults who have learning disabilities.

The home is located to the West of Hull city centre and is near to local amenities and public transport.

The home is owned and managed by a partnership and is a small family run business.

This inspection took place on 24/08/2015 and was unannounced. The service was last inspected 22/09/2014 and was found to be compliant with the regulations inspected at that time.

There was a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood they had responsibility to keep people safe from harm and had received training about how report any abuse they may witness or become aware of. The registered provider had procedures for staff to follow for the reporting of abuse and who to contact. Staff were provided in enough numbers to meet the needs of the people who used the service. The provider’s recruitment procedures ensured, as far as practicable people who used the service were not exposed to staff who had been barred from working with vulnerable adults. People received their medicines as prescribed by their GP and staff administered people’s medicines safely.

People were provided with a wholesome and nutritious diet which was of their choosing. Staff received training which equipped them to effectively meet the needs of the people who used the service. Training was updated regularly and as required to keep the staff’s skills current. Staff were supported to gain further qualifications and experience. People were supported to access health care professionals when needed and staff supported them to lead a healthy life style. Staff were trained in and understood the principles of the Mental Capacity Act [MCA] and understood when these principles applied.

People who used the service had good relationships with the staff who understood their needs. Staff respected people’s dignity, privacy and upheld people’s human rights and choices. People who used the service were involved in their care and had attended meetings to set goals and fulfil ambitions.

People could choose how to spend their days and the staff respected their choices. People’s preferences about how they wanted to be cared for were recorded and they had an input into the content of their care plans. Care plans described the person. There was a complaints procedure in place and people who used the service knew they had a right to complain and who these should be directed to.

People who used the service were involved with the running of the service, their opinions were sought and changes were made as a result of suggestions made. The registered manager undertook audits to ensure people received a safe service which effectively met their needs.

Inspection carried out on 22 September 2014

During an inspection looking at part of the service

We undertook this follow up inspection to check the provider had complied with the actions we had asked them to take following the last inspection in April 2014.

The provider sent us an action plan outlining how they intended to comply with action set.

During this inspection we found the provider had complied with the action we asked them to take.

The provider had undertaken surveys, produced reports and implemented new activities following consultation with the people who use the service, their relatives and health care professionals. This meant the people who used the service were able to air their views and make suggestion about how the service was run.

People told us they enjoyed having the meetings and had made some suggestions about activities.

Inspection carried out on 7 April 2014

During a routine inspection

The inspection was carried out by one inspector. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

� Is the service caring?

� Is the service responsive?

� Is the service safe?

� Is the service effective?

� Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

People�s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people�s wishes. People told us they were happy with the care provided at the service.

Is the service responsive?

The service had a complaints procedure which people could access. People can therefore be assured that complaints are investigated and action is taken as necessary. People who used the service were consulted on a daily basis about what activities they would like to undertake. There were also planned activities which included going out to day service. People were consulted about their care needs.

Staff followed instructions from visiting health care professionals for example GPs and district nurses. This ensured people received the care and attention they required to meet their needs.

Is the service safe?

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly, therefore not putting people at unnecessary risk.

The provider sets the staff rotas, they took people�s care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people�s needs were met.

The provider had policies and procedures in place for staff to follow to report any abuse they may witness or become aware of.

Is the service effective?

People�s health and care needs were assessed with them and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service well led?

The provider consulted with people about how the service was run and took account of their views. However, we found that the way the information was collated and reported did not reflect people�s views and was out of date. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the quality monitoring of the service

What people who used the service and those that matter to them said about the care and support they received.

People who used the service told us they were happy and they were satisfied with the care they received. Comments included, �This is a nice place, I am happy here�, �The staff look after me really well, they help to be independent�, �I like living here, I feel safe� and �I think this is better place than where I used to live.�

People also told us they were involved with their care plans. Comments included, �We have meetings where I talk about my care and the way I want to be cared for.� People also told us they knew who to go to if they had any concerns or complaints. Comments included, �I would see the staff, they would help me.�

Inspection carried out on 29 November 2013

During a routine inspection

We looked at three people�s care records which included their care plans, risk assessments and health plans. These were clear, person-centred, detailed and provided up to date information on how their diverse needs should be met.

Records showed people experienced a wide range of activities throughout the week including: baking; personal shopping; trips to the cinema; and meals out. One person told us, �I sometimes go to the pub and go swimming� and �I can usually go out whenever I want to.�

We were told discussions took place between staff and people who lived at the home to promote awareness of nutrition and hydration. One support worker commented, �Because we know each person very well, we know their preferences."

We looked around the home and observed a good overall standard of cleanliness. We saw people�s rooms were clean and communal areas were clean and tidy. The home was free from mal odour. One relative told us, �It�s brilliant; ever so clean.�

We saw each person�s care file contained an assessment of their ability to administer medication themselves. We noted one person�s assessment stated, �I require full assistance from appropriately trained support staff to administer my medication.�

We observed staff were attentive to people�s needs. People who lived at the home appeared at ease with the members of staff. We asked one person who lived at the home what they thought about the staff; they said, �They are great; really nice and friendly.�

Inspection carried out on 3 December 2012

During a routine inspection

We spoke or communicated with all of the people that used the service and they told us choice was offered and privacy respected. We saw that people were given appropriate information and this included the service user guide which gave clear information about what the person could expect when living in the home. People commented, "Yes the staff always knock before they come in" and "I go out everyday to the shops or for my lunch."

We saw that personal profiles and support plans were designed in an easy read format, they were individualised and included activity planning. This showed the person themselves had been involved in their development.

We observed the interaction between people who used the service and staff and saw this was carried out in a supportive, understanding and empathic way.

We spoke with people who used the service and they told us they were happy with the care and support offered to them. Comments included, "I like it here", "It's very nice", "Smashing" and "They (the staff) are all lovely." People also told us they felt safe and the home was always, �Clean" and "I love my bedroom."

Prior to our visit we spoke with the local authority contracting and safeguarding team, who told us they had no current concerns.

Inspection carried out on 1 November 2011

During a routine inspection

People told us that they were happy living in the home. They liked the staff and felt safe in the home.

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