We carried out a review of the data available to us about Dean View Villas on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Dean View Villas, you can give feedback on this service.
Dean View Villas is a residential care home providing personal care to up to 8 people. The service provides support to people living with a learning disability and/or autism. At the time of our inspection there were 6 people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
Staff supported people to access the community. 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.
Right Care:
People were supported to make daily living choices. There were positive relationships between people and staff, which meant people were treated with dignity and respect.
Right Culture:
Relatives told us there had been issues with staff turnover and different managers. Both relatives and staff confirmed the registered manager was making improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 7 September 2021).
At our last inspection we recommended the provider reviews people’s medicines. At this inspection we found the provider had improved.
Why we inspected
This inspection was prompted by a review of the information we held about this service. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dean View Villas on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Dean View Villas provides residential care for up to eight people who live with a learning disability and/or autism. At the time of inspection, five people were using the service.
People's experience of using this service and what we found
Risks to people were not always managed safely. Individual risk assessments were in place to keep people safe, however some assessments had not always been followed. Environmental risks identified during inspection were in part, identical to issues which had been raised in 2019 via the provider’s fire risk assessment. People’s medicines were for the majority managed safely. We did identify where one person’s allergies had not been included on their medication administration chart. We also identified where one person’s medication had not been reviewed on a regular basis as required. We have made a recommendation about this.
The registered manager had submitted appropriate documentation to the commission in line with the legal requirements of their registration. Various checks to monitor the quality of the service were in place, but some checks had not picked up issues identified during inspection. We shared ideas for improvement with the registered manager. We have also made a recommendation regarding the consistent recording of information within people’s daily notes.
People were protected from abuse. Staff had received training in safeguarding and were confident to identify various types of abuse. We did, however, identify issues in relation to the legal status of court appointed deputies for people regarding their health, welfare and finance. The registered manager agreed to look into this issue in order to provide clarity to this situation.
Staff recruitment was safe and staffing levels were appropriate to meet the needs of people. When things went wrong, lessons were learnt from these and were shared with staff to prevent reoccurrence. Infection control procedures were for the majority in place. Some issues were identified on the day of inspection and the registered manager took immediate action to address the issues.
People received person-centred care and staff were very proud and positive about the care people received. Relatives and professionals told us staff had the appropriate skills and training to care for people safely. Staff training was for the majority up to date, but we did identify one issue regarding staff refresher training for epilepsy.
Staff worked well with other healthcare professionals and regularly sought advice and guidance from GPs, dieticians and occupational therapists. People were supported to maintain a healthy and balanced diet. The environment was in need or redecoration. The registered manager told us they had already received approval for this and were awaiting quotes for the work to be done. People’s needs were assessed prior to living in the service and these assessments took into account people’s personal preferences, likes and dislikes.
The registered manager was working hard to make improvements to not only the service, but to staff morale also. Staff told us the change in the service was welcomed and they appreciated the changes the registered manager was making. Staff now felt supported and listened to. One staff member told us, “I love coming to work now, I didn’t before, but I do now, it has changed.”
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care and support provided to people living at the service maximised their choice, control and independence. People were involved as much as possible in all aspects of their care and future planning. Care provided at the service was centred around the person and promoted people’s dignity, privacy and human rights. The ethos, values, attitudes and behaviours of the management team and staff ensured people lead confident, inclusive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 24 October 2017)
Why we inspected
The inspection was prompted in part due to whistleblowing concerns received regarding poor care and practice. A decision was made for us to inspect and examine those risks.
We received concerns in relation to poor care and practice. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement This is based on the findings at this inspection.
We have found evidence that the provider needs to make some improvements. Please see the Safe and Well-led sections of this full report.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will seek assurance from the provider following this report being published regarding the changes they will make to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Dean View Villas is a residential care home that provides personal care to up to eight people with a learning disability or physical disability. There were five people living there at the time of the inspection. The service is provided from two adjoining bungalows, each with its own communal areas.
We found the following examples of good practice.
• Staffing levels were safe. Staff had volunteered to spend the entirety of the isolation period on site with people who used the service, sleeping in spare rooms. This ensured a continuity of care and reduced the chances of spreading infection.
• New signage including floor signage to help encourage social distancing was in place. Additional cleaning of all areas and frequent touch surfaces was in place.
• Stringent measures were in place to limit unnecessary visits to the service. All visitors had to undergo a temperature check and a range of questions.
• The new manager had responded proactively to external advice, including the repurposing of one room to ensure there was adequate office space and a space for staff to change clothing safely.
Dean View Villas is a residential care home that provides personal care to up to 8 people with a learning disability or physical disability. There were 6 people living there at the time of the inspection. The service is provided from two adjoining bungalows, each with its own communal areas.
People’s experience of using this service and what we found
The regional manager was working hard to improve the management and culture at the service. They had taken immediate steps to safeguard people and staff following concerns about how the service was managed.
Appropriate safeguarding policies and procedures were in place, with staff confident in how to use them. Staff had been supported to raise concerns internally where they felt the registered manager did not investigate matters appropriately; the regional manager had taken immediate, comprehensive and robust actions to ensure people were safe.
A comprehensive quality assurance programme was in place, with additional focus added recently on lessons learned, increasing staff autonomy and accountability, as well as increasing advocacy support for people who used the service.
The registered manager had not led the service well in recent months, leading to a less inclusive culture. The provider had made changes to ensure the culture was more open and inclusive recently. They had comprehensively addressed potential risks. People and staff were fully involved. Staff told us they felt valued and listened to by the regional manager and interim service manager, who had encouraged them to speak openly.
The provider had acted openly and transparently with CQC and all relevant external agencies to ensure people’s safety was paramount.
People told us staff were kind and they felt safe. This was confirmed in feedback from relatives.
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 24 October 2017).
Why we inspected
We undertook this targeted inspection to check on specific concerns that had been raised about the management and culture of the service. A decision was made for us to inspect and examine those risks.
The overall rating for the service has not changed following this targeted inspection and remains Good.
CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found no evidence during this inspection that people were at risk of harm from these concerns, due to the actions taken by the provider. Please see the Safe and Well-Led sections of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dean View Villas on our website at www.cqc.org.uk.
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 August 2015 we had rated the service as good. Improvements were required with regard to staff training and supervision. At this inspection we found that the improvements had been made and the service remained good.
Some people were unable to tell us about the service because of their complex needs. People appeared content and relaxed with the staff who supported them. Those that could speak with us told us that care was provided with kindness. Staff knew the people they were supporting well and we observed that care was provided with patience and kindness and people’s privacy and dignity were respected.
Detailed records accurately reflected the care provided by staff. Risks to people’s well-being were assessed and kept under regular review.
There were sufficient staff to provide safe and individual care to people. Staffing arrangements were flexible. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.
People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received a varied and balanced diet to meet their nutritional needs. Systems were in place for people to receive their medicines in a safe way.
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. Staff had an understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. However, we have made a recommendation about the Court of Protection arrangements that had been promoted by the organisation for some people as they were not independent of the organisation and could pose a conflict of interest.
People were provided with opportunities to follow their interests and hobbies and they were introduced to new activities. They were encouraged and supported to go out and engage with the local community and maintain relationships that were important to them.
Relatives and staff spoke well of the registered manager and they said the service had effective leadership. Systems were in place to enable people to raise complaints. People told us they would feel confident to speak to staff about any concerns if they needed to. The provider undertook a range of audits to check on the quality of care provided.
Further information is in the detailed findings below.
This inspection took place on the 3 August 2015 and was unannounced. This meant the provider did not know we would be visiting. We last inspected Dean View Villas on 5 August 2013 and found it to be meeting all legal requirements we inspected against.
Dean View Villas is a care home run by Community Integrated Care. It provides personal care
and accommodation for up to eight people with learning and physical disabilities. Dean View Villas is a purpose built care home; it comprises of two inter linked villas. All bedrooms are for single occupancy and are suitable for people who use wheelchairs.
At the time of the inspection there were eight people living at the service.
There was a well-established 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.
It was acknowledged by the registered manager that there had been some difficulties within the organisation in accessing training and ensuring it was kept up to date. They told us a new external training provider had now been engaged by the organisation and any training that was required had been booked. This included mandatory training as well as training that was specific to the needs of the people living at Dean View Villas.
Some staff had not received an annual appraisal or regular supervisions but matrixes were in place and were being used to identify when appraisals and supervisions were due. The registered manager and senior care staff were aware that priority needed to be given to completing these appraisal and supervision meetings. Care staff told us they felt well supported and were able to approach the registered manager and senior care staff for support and advice whenever they needed to.
Staff had a good understanding of safeguarding and whistleblowing and were aware of procedures to follow should they have any concerns.
Premises safety was well managed with relevant risk assessments and contingency plans in place. Staff were aware of fire safety procedures and there were specific evacuation plans detailing day time and night time procedures.
Accidents and incidents were recorded electronically and staff were aware that any incident should lead to a review of care records and risk assessments due to the possibility that a person’s needs may have changed.
Recruitment included pre-employment checks before staff started in post, which included a full employment history, references and a disclosure and barring service check. Staffing levels were such that people’s needs were met, and we saw that rota’s were flexible so additional staff were on shift on day’s where people had set activities or appointments that they needed to attend.
The staff team were proactive in safely managing people’s medicines and requested medicine reviews if they were concerned with regard to the amount of medicine people were prescribed. We observed staff discussing one person’s medicine with their doctor and this was done in a professional manner which showed mutual respect for each other’s knowledge and awareness.
There was a good understanding of mental capacity and deprivation of liberty safeguards. Care plans identified how to support people to make their own decisions and where staff were making decisions on people’s behalf this was completed in line with best interest decision making and involved the person, family members and other professionals in an appropriate and relevant manner.
The service had won an award in the North East British Care Awards 2014 for involving people in nutrition care, acting as advocates for people and challenging the system. Guidelines were in place from speech and language therapists in relation to supporting people with eating and drinking and this information had been used in the development of care plans and menu plans.
Health care needs were met with regular check-ups with dentists, chiropodists and opticians as well as doctors and district nurses.
We observed warm and caring relationships between staff and the people living at Dean View Villas. Staff were aware of people’s history and treated people with a great deal of respect and dignity. Staff asked consent before supporting people and were seen to actively engage with people in relation to involving people in keeping care records up to date.
Care records were specific to the person being supported and were written in a way which acknowledged people’s independence and preferences. Each person had a communication passport which detailed the best ways for staff to engage in conversation with people. People also had health plans which were used should people be admitted to hospital so nursing staff had relevant information on the person’s background, support needs and communication style.
People were supported to engage in activities of their choosing and lessons learnt logs were used to record what worked well about the activity and how care and support may need to change to make it a more enjoyable activity for people. Each month a ‘my memories’ sheet was completed which gave a record of all the memorable events that had happened for the person that month.
Pictorial information was available on the complaints procedures and visitors said they knew how to complain but said, “There’s nothing to complain about.” The registered manager felt this was because they had open lines of communication with people and their families and any concerns were openly discussed and resolved before there was a need for formal complaints to be raised.
There were a variety of audits in place to monitor and improve quality. The staff team had a culture which was driven by providing the best quality of life for people living at Dean View Villas. Staff actively engaged with people to raise money to make improvements to the environment and had raised sufficient funds to develop a sensory room for people and were in the process of discussing ‘dignity days’ which would be used as fundraising opportunities to further develop the garden so it was accessible for people who used wheelchairs.
The service planned and delivered care and support so that people's needs were met. Staff supported people in an engaging way and regular activities were arranged. One person told us that 'It's lovely' and a relative told us that the manager 'Puts her heart and soul into the place'.
The service had an effective recruitment and selection procedure in place and carried out relevant checks when recruiting staff.
The manager had systems in place to regularly check the quality of the care and people were consulted about the care received.
One person told us that they liked their food and liked living at Dean View Villas.