We inspected Saint John of God Hospitaller Services – 1-2 Dalby View on 9 December 2016. This was an unannounced inspection, which meant that staff and the registered provider did not know we would be visiting. When we last inspected the service in January 2015 we found that the registered provider was meeting the legal requirements in the areas we looked at.
The home had a registered manager. 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.
Dalby View is registered to provide care and support to people in two separate bungalows. The service provides care, support and accommodation to eight adults who have learning disabilities and / or physical disabilities. The service is close to all local amenities. At the time of the inspection there were eight people using the service.
People were protected by the services approach to safeguarding and whistle blowing. People who used the service told us they felt safe and could tell staff if they were unhappy. People who used the service told us that staff treated them well and they were happy with the care and service received. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and said that management acted appropriately to any concerns brought to their attention.
Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We did note there wasn’t a cyclical routine for the testing of fire call points which meant some call points had not been tested as much as others. The registered manager contacted us after the inspection to confirm they had taken action to address this.
Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. Risk assessments had been personalised to each individual and covered areas such as health, behaviour that challenged, falls, burns and scalds. This enabled staff to have the guidance they needed to help people to remain safe
There were sufficient staff on duty to meet the needs of people who used the service. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with people who used the service.
Appropriate systems were in place for the management of medicines so that people received their medicines safely.
Staff had received induction training and shadowed other more experienced staff when they were first recruited. The majority of staff had completed training in food hygiene, fire awareness, emergency first aid, moving and handling, safe handling of medicines and safeguarding. There were some gaps in training for behaviour that challenges, Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. We were informed that this training would take place early in the New Year.
Staff had an understanding of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards and acted in the best interest of people they supported, however at the time of the inspection, processes had not been followed to formally record this. Information was supplied to us after the inspection to confirm that staff at the service had commenced this process.
We saw that people were provided with a choice of healthy food and drinks, which helped to ensure that their nutritional needs were met.
People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.
There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were kind, caring, respectful, and interacted well with people. Observation of the staff showed that they knew the people very well and could anticipate their needs. People told us that they were happy and felt very well cared for.
People’s independence was encouraged. Activities, outings and social occasions were organised for people who used the service, however these had been limited in the last few months as some staff had left the service leaving a limited amount of staff available who were able to drive. We were told by the service improvement manager that new staff would be recruited in the very near future and there was a criteria that they must be staff who are able to drive.
People’s needs were assessed and their care needs planned in a person centred way. We saw that risks identified with care and support had been identified and included within the care and support plans.
The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.
There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.