Archived: Darley Cottage

Darley Cottage is a residential care home providing personal care for six people who have a learning disability and or autism. The home is in one adapted building, with facilities for a member of staff to stay overnight.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

There was a very positive, inclusive and person-centred culture at the home. Most people had lived at the home for a very long time; and they had benefitted from a very stable staff team that had supported them to achieve positive outcomes. The staff team cared about people and were very knowledgeable about their support needs; while remaining inquisitive and keen to learn. Feedback from staff was that they felt well supported in their roles.

In their speech and actions, staff treated people with respect and kindness. They provided people with individualised support that enabled them to be as independent as possible. People’s feedback reflected this. Their comments included; “I like living here”, “I like it here; I get up when I want, and I have my own routine” and “This home is very relaxed.”

Staff supported people to be as safe as possible. There were systems in place that had been effective in helping staff to identify risks in people’s support and day to day lives, whilst respecting their freedom and choice. People were safeguarded from the risk of abuse.

People were supported to make their own decisions, staff respected these and promoted people making decisions as much as possible. Staff listened to people, didn’t interrupt them and enabled them to take the lead. This was done in a respectful, enabling and everyday manner.

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.

Planning and documenting people’s care was done in a very respectful and creative manner. Each person’s plan was personalised, completed in partnership with them and contained key information that was meaningful to the person.

Staff made best use of any opportunities for learning. For example, records of any accidents and incidents were detailed, including even minor events and near misses to increase the opportunities for learning and improving. Alongside this the provider had an effective series of audits on the safety and quality of the care being provided.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s privacy and dignity was respected. Darley cottage was designed and maintained to have a homely feel and to blend into the neighbourhood. People were supported to be as independent as possible, in a natural and everyday manner in an unrestrictive environment.

For most specific and significant decisions, the principles of the MCA had been applied. Documents showed how people had been supported to make their own decisions as much as possible; and if they were unable how the decision made was in the person’s best interests.

We have made recommendations that the provider review the staffing rota and documenting how people had been supported to make key decisions.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 20 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection in January 2015, the service was rated good. At this inspection we found the service remained good.

The registered provider had systems in place to ensure the safety of the people who used the service. This included arrangements for identifying, reporting and taking action on any allegations of abuse. This was reinforced through training for staff, staff knowledge and reporting processes. People’s safety was further enhanced through assessments for individuals identifying risks they faced from the environment or from risks associated with their own health and social needs. The registered provider ensured that a system for the safe management of medication was in place and that the premises were well maintained and hygienic.

The registered provider took the requirement of the Mental Capacity Act 2005 (MCA) and associated safeguards into account. This meant they were working within the law to support and assist people who may lack capacity to make their own 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 support this practice.

People who used the service were supported by a staff team who had received the training and had the knowledge to best support them. The nutritional needs of people were met. Consideration was made to the dietary needs of people and their personal preferences. People who used the service were involved in shopping for food and occasionally assisted in preparing it.

Staff interactions were friendly, caring and supportive. People were supported in a patient and respectful manner. Staff ensured that people were treated as individuals and had their privacy and dignity taken into account through care practice. People were given information about their care and the support they could be provided with. People were encouraged to make choices concerning their daily lives and the support provided by staff was directed by these choices and preferences.

Care plans provided staff with the information they needed to successfully support people in all aspects of their daily lives. These were person centred and detailed with evidence outlining that people were actively involved in them. Care plans were reviewed and updated when required.

People undertook activities which were linked to their personal preferences. Some people were involved in voluntary work in the local community and this was fully supported by the staff team.

Information was in place in respect of how people could make a complaint. This was presented in a format appropriate to the communication needs of people. Complaints records were maintained and concerns responded to in a timely manner.

The registered manager used a variety of methods to assess and monitor the quality of the support provided at Darley Cottage. These included regular audits of the service and staff and resident meetings to seek the views of people about the quality of care being provided. The registered manager had provided feedback to people about the rating that we had applied at our last visit. The registered manager always notified us of significant incidents within the service as required. A robust system of audits enabled the registered manager to identify those areas of support that required either improvement or development.

Further information is in the detailed findings below.

"We like the staff"

"They take notice of what we say"

"I am well but if I was not, they would get me to see a Doctor"

"I feel safe living here and have no worries"

"They look after me and they will help me"

"I get my tablets when I need them and the staff never miss me out"

"If I was not happy with something I would talk to the staff and they would sort it out"

This visit found that records relating to the care of individuals were accurate and up to date and this in turn enabled the care and welfare of people to be promoted. We found that the social and health needs of people were maintained and that action was taken to ensure that people had access to the medical services they required. We found that individuals were protected from abuse and as a result felt safe with the staff team. We found that people's health was maintained by the safe management of medication. The complaints procedure gave individuals the opportunity to voice concerns and was presented in a format appropriate for their needs. Care plans were presented in a pictorial form and were accurate. Their format and evidence of people being involved in reviews of care plans provided evidence that support was inclusive.

We observed staff interactions with people. These were positive and friendly. Staff provided a focus for individuals to refer to and people appeared relaxed and at ease with the staff team.

People experienced care, treatment and support that met their needs and protected their rights through good care planning and risk assessments. One person who used the service said, "I have seizures and the worker that is with me looks after me. We have birthdays with a cake. The food is nice."

We found that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The staff members we spoke with said that they felt supported. Two members of staff said, "I love working here."

The provider had an effective system to regularly assess and monitor the quality of service that people receive. One family member said, "We think it is very, very good. We have no complaints. We are always welcomed." The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. One person who used the service said, "I like living here."