Dent House Nursing Home

The home provides accommodation over two floors and people have shared access to communal rooms and bathrooms. At the time of the inspection the home was fully occupied. Most people had lived there for some time and included people living with learning disabilities and physical disabilities.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. However, people were given choices and their independence and participation within the local community was being encouraged.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post who was there at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission 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.

People continued to receive care that made them feel safe and staff understood how to protect people from abuse and harm. Risks to people were assessed and guidance about how to manage these was available for staff to refer to and follow. All staff were clear about action they would take. Recruitment of staff was carried out to ensure that adequate numbers of suitable staff were available to support people. People received medicines as they were required.

People continued to receive effective support from staff who had a sufficient level of skills and knowledge to meet their specific needs. People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible, whilst involving them as much as possible to make decisions. The policies and systems in the home supported this practice.

People continued to be cared for by staff who displayed kindness and compassion in ways that upheld their privacy and dignity. Staff ensured that people were supported to make choices and maintain a good level of independence in line with their abilities and wishes. People’s diverse needs were recognised and support and access to activities was supported and enabled by staff.

The provider had effective systems in place that were used to regularly review people’s care and support that had been provided. Care plans and detailed assessments were individual and contained a wealth of information about people, their needs, their wishes and cultural needs.

People using the service were well known by staff and the staff team continued to work consistently to ensure that support provided respected their needs. People’s own communications methods were well known and understood by staff who were keen to advocate on behalf of people whenever they were unhappy, wanted to make preferences known, or wanted to raise an issue.

The care home continued to be well-led, with checks and monitoring arrangements used to maintain the quality of the service provided. Staff were positive about the leadership and skills of the registered manager and people using the service had a good relationship with the registered manager too. Required information was available in the home and made available when requested.

Further information is in the detailed findings below.

At our inspections on 13 and 17 February 2014 we found the registered manager had moved to another home and a new manager had been employed at Dent House. The new manager told us they were applying for registration with the Care Quality Commission (CQC).

We spoke with the manager and deputy manager, people receiving care and staff at the home. People living at the home told us they felt safe and had no concerns about the way they were cared for. We found that systems to ensure people were protected were improved.

We found the provider had introduced new systems to ensure health and safety, incidents, staff training and complaints and concerns were monitored and action taken where required. This helped to ensure people were protected from unsafe or inappropriate care at Dent House.

We saw that suitable and safe equipment was provided to promote people's independence and comfort at the home.

Staff received training in safeguarding people at the home from abuse. We found that they were aware of procedures for protecting people from abuse and reporting any concerns. The provider had not, however, made suitable arrangements to ensure that people with behaviours described as "challenging" who needed to be restrained to keep them safe were fully protected from abuse.

We found that there were inadequate systems in place to assess and monitor the care people received and fully manage risks.

We examined care files, and found that consent was being obtained for people's care. We saw that care plans were detailed and personalised. Risks were also assessed and managed, and people had positive behaviour support strategies to help them if they felt anxious, angry or upset.

We looked at medication systems at Dent House, and saw that medicines were stored and administered safely.

We found that staff were trained to provide appropriate support for people, and that this included specialist training to meet people's particular needs.

We saw that Dent House made their complaints procedure available to anyone connected with the service, and that concerns and complaints were correctly recorded and responded to.