Archived: Dale House

Updated 5 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We visited the service on 27 and 28 June 2016 and the inspection was unannounced. The inspection team consisted of one Adult Social Care Inspector.

We spent time speaking to people and observing people in the communal areas of the home. We spoke with five people who used the service. We spoke with five members of staff: the area manager, the registered manager and three care staff. Following the inspection we spoke with three relatives of people who used the service.

During the inspection visit we looked at three people’s care plans, risk assessments, staff training and recruitment files, a selection of the home’s policies and procedures, IT systems, meeting minutes and maintenance records.

Before our inspection we reviewed all the information we held about the service. We also examined notifications received by the CQC. We spoke with professionals in local authority commissioning teams, safeguarding teams and Healthwatch. Healthwatch is the local consumer champion for health and social care services. They give consumers a voice by collecting their views, concerns and compliments through their engagement work . No concerns were raised regarding the service by these professionals. We spoke with three external healthcare professionals who also raised no concerns about the service.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a document wherein the provider is required to give some key information about the service, what the service does well, the challenges it faces and any improvements they plan to make. This document had been completed and we used this information to inform our inspection.

Updated 5 August 2016

The inspection took place on 27 and 28 June 2016 and was unannounced. This meant the provider or staff did not know about our inspection visit.

We previously inspected Dale House on 25 July 2014, at which time the service was compliant with all regulatory standards.

Dale House is a residential home in Dipton, Stanley, County Durham, providing accommodation and personal care for up to 9 people living with learning disabilities. There were 9 people using the service at the time of our inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like directors, 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.

People who used the service and their relatives expressed confidence in the ability of staff to protect people from harm.

There were sufficient numbers of staff on duty in order to safely meet the needs of people using the service and to maintain the premises. All areas of the building including people’s rooms, bathrooms and communal areas were clean. Where one room required refurbishment we saw this was factored into the service development plan for the year.

Staff displayed a good knowledge of safeguarding principles and what they would do should they have any concerns. We saw evidence of concerns being raised promptly and decisive action being taken to keep people safe.

There were effective pre-employment checks of staff in place, including Disclosure and Barring Service checks, references and identity checks.

The storage, administration and disposal of medicines was safe and in line with guidance issued by the National Institute for Health and Clinical Excellence (NICE).

Risk assessments were in place to manage the risks people faced. These were reviewed regularly and staff displayed a good knowledge of how to reduce these risks.

There was prompt and regular liaison with GPs, nurses and specialists to ensure people received the treatment they needed.

Staff were trained in areas specific to meeting people’s needs, for example Makaton training, which supports people to use symbols to communicate with others. We also saw staff were trained in areas the provider considered mandatory, such as safeguarding, health and safety, moving and handling and dignity.

Staff were supported through regular supervision and appraisal processes as well as regular team meetings.

We saw people who required specialised diets had their needs met and people had choices at each meal, as well as a range of alternatives.

Group activities including fortnightly outings took place and improvements were planned to ensure people who could not choose to engage in group activities had more one-to-one support.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working within the principles of the MCA. The registered manager displayed a good understanding of capacity and we found related assessments and decisions had been properly taken and the provider had followed the requirements in the DoLS.

The atmosphere at the home was vibrant and welcoming. People who used the service, relatives and external stakeholders told us staff were compassionate and we saw numerous friendly and caring interactions by staff.

Person-centred care plans were in place and regular service user forums ensured people’s preferences were acted on. We saw regular reviews took place with the involvement of people, their family members and relevant professionals.

The service had built and maintained good community links, pro-actively involving the community in fundraising.

Staff, people who used the service, relatives and an external professional we spoke with had confidence in the registered manager, particularly with regard to their passion and competence in providing high quality care to people who used the service.