Archived: Dee House

Dee House provides accommodation and personal care for up to nine people who have mental health needs. Accommodation for residents is comprised of nine single rooms, two lounge areas, a dining room, kitchen and separate laundry. The service is within walking distance of local amenities and bus routes.

The registered manager had worked at the service since it opened 25 years ago. The registered manager had been registered with the Care Quality Commission (CQC) since September 2011. 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.

The last inspection of Dee House was carried out in May 2014 and we found that the service was meeting all the regulations we assessed.

People who used the service said they felt safe. Staff knew about the systems in place to protect people from the risk of harm and they also knew how to recognise and respond to abuse correctly.

There were sufficient staff on duty to ensure the needs of people were met. Effective recruitment processes were in place and were followed by the service. Staff received on-going training and support to ensure they carried out their role effectively.

Medicines were managed safely and processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. People received care and support from staff that knew them well, and had the knowledge and skills to meet people’s individual needs. People told us staff always treated them well and promoted their choices regarding their care, support and the activities they participated in. People spoke positively about staff, their comments included, “The staff are all friendly and approachable” and “I like all the staff”.

People’s risks were anticipated, identified and monitored. Staff managed risk effectively and supported people’s decisions, so they had as much control and independence as possible.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and DoLS to ensure that people who could not make decisions for themselves were protected.

People had enough to eat and drink. People were offered drinks and snacks throughout the day. People who were at risk of poor nourishment were regularly weighed.

Staff were patient and friendly and knew people well. Staff interacted well with people and engaged in conversation with them about things of interest.

People’s care and support needs were up to date and reviewed on a regular basis with the person or other appropriate people. Staff provided people with person centred care and support.

No formal complaints had been made to the registered provider since the last inspection in May 2014. People were aware of how to make a complaint if required and they told us they would not be worried about complaining if they needed to. People were confident that their complaints would be listened to and acted upon.

Systems were in place to regularly check the quality of the service provided and to ensure improvements to the service were made. The registered manager and staff established good working relationships with family members and visiting professionals to the benefit of people who used the service.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that staff treated people who used the service with respect. We noted that the needs of people were addressed at all times. Interactions between staff and people who used the service were friendly, respectful and positive. Staff demonstrated patience in reassuring and interacting with some people. People who used the service told us that they felt safe living there. We saw that risk assessments designed to keep people safe were updated regularly and with the involvement of the people they related to.

Is the service effective?

There was information on an advocacy service available if people needed it, this meant that when required people could access additional support. All people had been assessed as having the capacity to make their own decisions about their own lives.

People's health and care needs were assessed on a regular basis and this work was done to conjunction with the people they related to. In some cases, dietary needs were tailored to the health needs of people with the devising of their own menus. We also saw evidence that when it was safe to do so, people were encouraged to be independent in managing their own medication.

Is the service caring?

Our observations noted that staff were attentive to the needs of the people and that their work focussed exclusively on their needs. People we spoke with told us that staff cared about them. They told us that they were 'great', 'caring', 'went the extra mile' and one person said that it was 'great living here, you should come and live here for a week'.

Is the service responsive?

The service had quality assurance processes in place which sought the views of people involved in the support of people living at Dee House This was done through supervision and appraisal of staff, quality audits from the provider, visits from local Healthwatch and visits from the local authority contract team. The manager considered that the service had benefitted from a recent Healthwatch visit. Staff considered that they were listened to and supported by the provider. We saw evidence in health records demonstrated that as soon as new health conditions arose, the staff team ensured that people received prompt referral to medical agencies. We also saw evidence through care plans that as needs changed; plans were amended and reviewed on a regular basis.

Is the service well-led?

The service had a manager who was registered with us to carry out their roles. We noted that the service always told us when there were significant incidents. The service remained part of a larger organisation which had systems in place to ensure that people received a person centred level of support. We saw evidence in care plans that the service worked with other agencies to ensure positive outcomes for people.

You can see our judgements on the front page of this report.

Other comments made included:

"This is a home from home"

'I Can't fault it, the Staff are good and they keep in touch"

"If had any concerns I would just talk things over'

'As a relative, I have peace of mind now'

"Staff encourage our independence and they have respect for our privacy and dignity"

Our observations noted that Dee House provided a friendly and caring environment and that the welfare and well being of people was important to the staff team.

You can see our judgements on the front page of this report.

"I feel safe here"

"The staff are Chester's finest"

"The staff are fabulous. They are really very good"

People who used the service told us they were involved in the planning of their care. We looked at three care plans that confirmed this practice.

We observed staff and people who used the service positively interacting during a Christmas carol service that was organised by the home and the Salvation Army.

We spoke to three members of staff who worked at Dee House. Comments from them included

"I get real enjoyment out of my job"

"There is not a day when I don't enjoy coming to work"

We contacted Chester and Cheshire west local authority prior to our visit. They confirmed they have received no concerns about Dee House.