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Inspection carried out on 31 August 2017

During a routine inspection

Dean View Villas is registered to provide accommodation and personal care to a maximum of eight people who have a learning disability or physical disability.

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.

Inspection carried out on 03 August 2015

During a routine inspection

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.

Inspection carried out on 5 August 2013

During a routine inspection

Some of the people using the service had complex needs which meant they were unable to tell us their views. Because of this we used a number of different methods to help us understand their experiences.

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.

Inspection carried out on 24 August 2012

During a routine inspection

People we spoke with told us that they liked the people who worked there and they confirmed that staff helped them when they needed anything.

One person told us that they liked their food and liked living at Dean View Villas.

Reports under our old system of regulation (including those from before CQC was created)