The Daltons

We found the following examples of good practice.

Systems were in place to prevent people, staff and visitors from catching and spreading infections.

The provider robustly screened visitors for COVID-19, using temperature checks and a health declaration. The provider required visitors to have a negative lateral flow test before entry, and appropriate vaccination status checks were in place.

The service was very clean, tidy, spacious and well maintained. A robust cleaning schedule was in place which included additional cleaning of frequently touched areas such as door handles. Windows were open where possible to support good ventilation.

Staff were observed to be wearing appropriate PPE and the service had ample supplies. PPE stations were discreet but readily available to staff. Used PPE was disposed of appropriately.

Staff and people took part in regular testing in line with government guidance. Staff had received infection control training, and this was considered in regular staff supervisions and appraisals.

The provider had robust IPC policies and risk assessments in place. Infection control audits and checks were carried out. The registered manager had regular meetings with the provider and passed on important information about COVID-19 to staff.

The registered manager and deputy manager had an excellent understanding about the impact of the pandemic on the young people they supported. They recognised the particular difficulties they faced and did all they could to make reasonable and safe adjustments to support people and meet their needs.

The Daltons is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Daltons accommodates up to 6 people up to the age of 26 who have additional learning needs and/or mental health issues. The home provides people with opportunities to develop independence skills and coping strategies. On the day of our inspection there were six people using the service. People who used the service and their relatives were complimentary about the standard of care at The Daltons.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The registered manager understood their responsibilities about safeguarding and staff had been trained in safeguarding vulnerable adults. The home was clean, spacious and suitable for the people who used the service. The provider had effective procedures in place for managing the maintenance of the premises and appropriate health and safety checks were carried out. Accidents and incidents were appropriately recorded and risk assessments were in place where required. Appropriate arrangements were in place for the safe management and administration of medicines.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty to meet the needs of people who used the service. Staff were supported to provide care to people who used the service through a range of mandatory training, supervision and appraisal. Staff said they felt supported by the registered manager.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. People had access to healthcare services and received ongoing healthcare support.

The service complied with Article 12 of the UN Convention on Children’s Rights which states every child has the right to express their views, feeling and wishes in all matters affecting them, and to have their views considered and taken seriously. The service had arrangements in place to give people a voice in matters which affected them.

Staff treated people with dignity and respect and helped to maintain people’s independence. People were offered choices by staff to participate in activities which supported their growth and learning as well as increased their confidence.

The service commissioned a psychologist who visited the service weekly to provide support to people and staff. This meant there was a psychological perspective in the service which promoted people’s growth and potential.

Care records showed people’s needs were assessed before they started using the service and care plans were written in a person-centred way and reviewed regularly. Person-centred is about ensuring the person is at the centre of any care or support and their individual wishes, needs and choices are taken into account.

The provider had an effective complaints procedure in place and people who used the service and their relatives were aware of how to make a complaint. The provider had a quality assurance process in place. People who used the service and staff were regularly consulted about the quality of the service through meetings and surveys.

At the last inspection in August 2014 we found the registered provider was compliant with the regulatory requirements.

The Daltons provides accommodation for six people up to the age of 26 who have additional learning needs and/ or mental health issues. It is located in a village with good local transport links into Seaham, the nearest town. The staff see the home as transitional accommodation which provides people with opportunities to develop independence skills and coping strategies.

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.

Staff were able to describe to us what actions they took to safeguard the people in the service. This included using information available to them to support people make decisions about their relationships.

The service had risk assessments in place for the building and the environment. These were updated on a regular basis. The people who used the service also had risk assessments in place and guidance was provided to staff to ensure the risks to people were minimised.

We found the service complied with the Article 12 of the UN Convention on Children’s Rights which states every child has the right to express their views, feelings and wishes in all matters affecting them, and to have their views considered and taken seriously. We found the service had arrangements in place to give people a voice in matters which affected them.

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. We found the service not only complied with the framework but also supported the people to increase their understanding and capacity to make decisions.

With the agreement of the registered provider the registered manager had put in place a range of training in a training plan in which could be delivered at times when the running of the service would not be disrupted. We also observed a member of staff being coached by a visiting psychologist about how to work with a person on a particular subject.

We found there was a range of communications systems in place to support a flow of information and keep staff informed about the actions and needs of people using the service.

Staff promoted the independence of people by working with them on practical skills. Staff also recognised that independence required confidence and resilience in people which they promoted.

The registered provider had used an electronic system to identify people’s patterns of behaviour and had identified times in the week where a person was most at need. Actions had been put in place to ensure the needs could be met.

We found powerful examples of how the service had impacted on the lives of people using the service. Details of the examples we found cannot be disclosed in this report as it may lead to the people being identified.

We found choice was a key issue in the service. We found young people were offered choices by staff to participate in activities which supported their growth and learning as well as increasing their confidence.

Staff were aware of the importance of the environment to ensure people had stability at The Dalton’s before they could engage in a therapeutic process.

Care planning was regularly reviewed and the care plans gave a context about the people’s needs as well as providing a rationale about how people should be treated.

The service commissioned a psychologist who visited the service weekly to provide support to people and staff alike. This meant there was a psychological perspective in the service which promoted people’s growth and potential.

The registered manager demonstrated to us they were passionate and committed to the service. They spoke about making sure the home was comfortable and people were able to develop whilst living at The Daltons.

The registered manager completed a monthly report for the registered provider each month which detailed the progress the service had made and any events which had occurred in the service. The registered manager gave details of actions they had taken.

The service had in place surveys to monitor the quality of the service. At the time of our inspection the registered manager was awaiting further responses before analysing them to measure the service.

People who use the service told us "it's ok here, I get on well with the staff", "I am supported to go to college", and "I don't like it here they treat me like a kid".

We observed how people were cared for and spoke with staff and senior management so we could understand their experiences of care.

People we spoke with talked positively about the service, they told us about their involvement with planning their care such as deciding what activities they wanted to participate in. We also found people were well integrated into their local community and

received support to be as independent as possible.

We found care planning and risk assessment contained sufficient information to ensure people's needs were met. The service had used its in-house clinical team to assist in the writing of guidelines for people's care, so staff working with people could understand their needs and manage complex behaviours effectively.

People who used the service were protected from the risks of medication errors because the service had a system in place to ensure people received their medication in accordance with the prescriber's instructions.

The service had a quality and monitoring system which ensured people received safe and effective care. The service carried out a range of audits to look at care planning, medication and the environment.

Three young people were at college during the period of our inspection visit.

We spoke with one person who lived at the home. She said, 'It's a nice place. This home's much better than others I've been in. The staff are amazing here.'

We found people were encouraged to lead independent lives and their rights to privacy and dignity were respected at The Daltons.

We saw the premises were well maintained and had a welcoming, homely feel.