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The Duke's House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 July 2021

The Duke's House is a residential care home providing accommodation, support and personal care for people who have a learning disability or autistic people. At the time of our inspection seven people were living at the home; the home can accommodate up to eight people. The home is in a residential area of New Brighton, across two three story Victorian properties which have been joined. Each person has a private en-suite room. There are communal lounges, a dining area, an accessible kitchen and office space on the ground floor.

At our previous inspection three people were living at The Duke’s House whilst building work was taking place. Following the renovations, five people moved into the home from the providers other homes as part of a remodelling of their services.

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

The service design and environment did not meet all people’s needs as outlined in their support plans. Some people’s known actions were those that caused upset and were likely to get a negative response from other people in the home. Our observations and feedback from health and social care professionals, people’s family members and staff; confirmed that the combination of these risks and the atmosphere they created was having a negative impact on people’s wellbeing.

There were enough staff to meet people’s needs. However, staff members told us that at times there was not always enough staff available to support people; and this has had a negative impact on people being able to do things they wish to do.

People’s family members, staff and outside health and social care professionals told us that there had been a very high turnover of staff and the staff team had remained unstable since our last inspection. One health and social care professional told us, “Staff turnover is massive.” Making effective improvements based upon learning from incidents and feedback from people; had been hindered by a high turnover of senior staff, high turnover of support staff and a lack of stability within the service.

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.

This service was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The model of care and setting did not meet all people’s needs or maximise positive outcomes for them. The model of accommodation did not promote people living an ordinary lifestyle.

Right care:

• Staff were caring and kind towards people. However, people’s care was not always provided in a person-centred way, based on what was important to them. People's family members told us the provider had not worked in partnership with them in a meaningful way.

Right culture:

• There had been an extended period of change within staff teams and change of leaders within the service. Staff members described fractured teams. Health and social care professionals and people’s relatives criticised the provider’s communication and partnership working. Some people’s relatives told us they thought the provider needed to rebuild relationships and trust with them.

There was a system in place for recording and reviewing any safeguarding concerns. Referrals had been made to the local authorities safeguarding team. People and their family members told us they felt safe with staff members, who treated people well.

Managers and staff had responded appropriately to the COVID-19 pandemic. People supported each had a COVID-19 risk assessment and management plan in place.

There was a new home manager in place who was making an application to be registe

Inspection areas

Safe

Requires improvement

Updated 15 July 2021

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 15 July 2021

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 15 July 2021

Responsive

Requires improvement

Updated 15 July 2021

Well-led

Inadequate

Updated 15 July 2021

The service was not well-led.

Details are in our well-Led findings below.