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We are carrying out a review of quality at Derwent House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 10 December 2018

This unannounced inspection took place on 6 November 2018. It was prompted by the outcome of a safeguarding investigation which had been carried out by the local authority and the allegation had been substantiated.

At our previous inspection in March 2018 we found that the provider was in breach of six regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We had served two warning notices and asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective and well led to at least good. At this inspection we found that the quality and safety of the service had deteriorated and there were serious areas of concerns and ongoing breaches of regulations. The overall rating for this service is Inadequate which means it will be in special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Derwent House is a residential care home registered to provide accommodation and personal care for up to 14 people with a learning disability. The house is next door to another of the provider's services and has one shared bedroom and shared toilet and bathroom facilities. At the time of the inspection 13 people were living there. We inspected this service within the principles of Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion and promote people with learning disabilities and autism using the service living as ordinary a life as any citizen. We found that the model of care at Derwent House was not supportive of these principles and that people did not have choice and control over their day to day lives.

There was a registered manager in post. 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.

The provider had not taken action to ensure that people were safeguarded from abuse. They had failed to respond and learn lessons from an incident that had resulted in psychological abuse of some people who used the service. There were still insufficient safely recruited staff to meet people's assessed needs. The provider could not be sure that staff were trained and safe to fulfil their roles.

The service did not always

Inspection areas

Safe

Inadequate

Updated 10 December 2018

The service was not safe.

People were not always safeguarded from the risk of abuse and lessons were not always learned following incidents that had resulted in harm to people.

There were insufficient numbers of staff. Safe recruitment procedures had not been followed to ensure staff were of good character and fit to work with people.

Risks associated with health and community access were assessed and minimised.

Medicines were stored and administered safely.

Control measures were followed by staff to prevent the spread of infection.

Effective

Requires improvement

Updated 10 December 2018

The service was not consistently effective.

People's holistic needs were not being met in line with national guidance.

The provider could not be sure that staff were trained to fulfil their roles effectively.

The environment meant that not everyone had a right to privacy.

People were supported to eat and drink food of their liking.

The principles of the MCA were being followed.

People had access to a range of health care professionals if their needs changed or they became unwell.

Caring

Requires improvement

Updated 10 December 2018

The service was not consistently caring.

People were not always treated with dignity and respect and their right to privacy was not always upheld.

People told us they were asked about their care and support and that their choices were respected.

Responsive

Requires improvement

Updated 10 December 2018

The service was not consistently responsive.

People did not always receive care that met their assessed needs.

People were supported to access the local community and with hobbies and activities of their liking.

The provider had a complaints procedure.

End of life plans were in place for some people who used the service.

Well-led

Inadequate

Updated 10 December 2018

The service was not well led.

The culture of the service did not ensure that people were provided care and support with the principles of national guidance. There was no vision or plan for future care provision.

The provider had not taken action to ensure that people were safe from abuse and had sufficient staff.

The provider's governance systems had not identified areas that required improvement.

Staff felt supported and liked the management.