We carried out a review of the data available to us about Deerhurst on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Deerhurst, you can give feedback on this service.
Deerhurst is a small residential care home which provides accommodation, care and support for up to three people with a learning disability and autism. The home is located in a quiet cul-de-sac within a housing estate. People’s rooms are located on the first floor which are accessed by stairs. The home has a lounge and conservatory, a kitchen and a separate dining room and a large garden. At the time of the inspection there were three people living at the home.
People’s experience of using this service and what we found
People received person centred support which met their wishes and preferences. People’s support plans were detailed and up to date and showed they were involved in decisions about their support and chosen activities. People were asked for their ideas for activities and staff checked afterwards whether people had enjoyed them. The most recent survey feedback from relatives about the support their family members received was very positive and they felt involved and informed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The rating at the last inspection was good. The rating has not changed as we have not looked at all questions under the key KLOES.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The inspection was prompted in part due to concerns received that people may not be receiving appropriate, person centred care and may not have support to share their views and wishes. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection to support these concerns.
Please see the responsive section of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Deerhurst on our website at www.cqc.org.uk.
The overall rating for the service has not changed following this targeted inspection and remains good.
We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Deerhurst is a 'care home' registered to provide accommodation and personal care support for up to three people living with a learning disability, mental health needs, sensory disability and/or autistic spectrum disorder. At the time of this inspection there were three people living there, ages ranging from under to over 65.
People’s experience of using this service:
People living at Deerhurst received personalised support which met their needs and preferences. Support plans included information about people’s communication, which was well understood by staff.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the polices and systems in the service supported this practice.
People living at the service were protected from abuse because staff had received training and were confident in raising concerns about people’s wellbeing. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable. Safe medicines practice was understood.
People’s rights regarding capacity and consent were respected and the service had anticipated potential complications of a lack of capacity in advance. This helped to ensure for example the person could receive appropriate treatment in line with their best interests in an emergency.
Outcomes for people using the service reflected the principles and values of Registering the Right Support in that people had opportunities to be involved with their local community, and experience as many activities and choices as possible. People were asked throughout the day about what they would like to do. Pictures and photographs were used to support people’s understanding of choices for example regarding menu options.
People and their relatives were involved in the planning and delivery of their care. Risks to people’s health, safety and wellbeing were assessed and acted upon. Risk assessments gave staff clear direction on how to minimise risks for people, for example for long term health conditions or distressed behaviours.
People’s care and support plans were followed in practice. Staff knew people well and enabled them to share their views and live as independently as possible.
People were supported by kind and caring staff who worked hard to promote their sense of wellbeing, which they told us was very important to them. Staff were provided with the training, supervision and support they needed to care for people well. Where agency staff supported people, they were regular staff who knew people’s needs and any risks in relation to their care.
Effective quality assurance systems were in place to assess, monitor and improve the quality and safety of the services provided. People and their relatives were consulted over their care and the service was working to improve systems to make results of this more meaningful to people living at the service.
Rating at last inspection: This service was last inspected on 30 and 31 May 2017 and was rated good overall and in every key question.
Why we inspected: This inspection was a planned inspection based on the previous rating.
Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.
For more details see the full report which is on the CQC website at www.cqc.org.uk
The inspection was announced and was carried out on 30 & 31 May 2017 by one inspector.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.
People and staff told us they felt the home was safe. Staff had received safeguarding training and explained the action they would take to report any concerns.
Individual and environmental risks relating to people’s health and welfare had been identified and assessed to reduce those risks. Plans were in place to manage emergencies. Regular safety checks were carried out on the environment and equipment.
Systems were in place for the storage and administration of medicines, including controlled drugs. People received their medicines from staff who were appropriately trained and regularly assessed.
There were safe recruitment procedures in place and sufficient staff were deployed to meet people’s needs. People were supported by staff who had received appropriate induction, training and supervision.
People were supported to maintain their health and well-being and were referred to healthcare services when they needed them. People were offered enough to eat and drink and their specific dietary needs were met.
People’s rights were protected because staff understood the principles of the Mental Capacity Act 2005 and ensured decisions were made in their best interests. The registered manager understood the Deprivation of Liberty Safeguards and had submitted requests for authorisation when required.
Staff were kind and caring, treated people with dignity and respect and ensured their privacy was maintained. People were encouraged to maintain relationships with family and friends and visitors were welcome at any time.
Initial assessments were undertaken before people moved into the home to ensure their needs could be met. People had person centred support plans and their relatives or other representatives were involved in decisions about their care planning. People had access to a wide choice of activities, both at home and in the community.
Easy read complaints procedures were available and complaints were appropriately addressed. People and relatives were encouraged to give their views about the service.
Staff felt supported by the registered manager who provided clear leadership and guidance. Staff felt listened to and involved in the development of the service.
Quality assurance systems and audits were in place to help drive improvements. Incidents and accidents were recorded and actions taken and any learning shared with other homes within the company.
Deerhurst is a small residential care home which provides care and support for up to three people with a learning disability and autism. The home is located in a quiet cul-de-sac within a local housing estate. People’s rooms were located on the first floor which were accessed by stairs. One of the rooms had an ensuite bathroom, the two remaining rooms shared a shower. In addition the home had a lounge and conservatory, a kitchen and separate dining room, a laundry and a staff office. The home had a large garden to the rear of the property and parking to the front. At the time of the inspection there were three people living at the home.
The service had a registered manager. 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 and associated Regulations about how the service is run. The registered manager was also the registered manager of another of the provider’s nearby service and split their time equally between the two services.
People told us they felt safe living at Deerhurst and our observations indicated they felt relaxed and comfortable in the presence of their care workers and responded positively when staff approached them or offered them support.
We found, however, that some improvements were needed. People were not always protected from risks associated with the environment. The provider’s governance arrangements needed to be more robust to ensure that all of the risks to people were monitored and appropriate action taken when a risk identified.
People’s medicines were managed safely and there were appropriate systems in place for obtaining, storing, administering and disposing of medicines.
Staff had received training in safeguarding adults and had a good understanding of the signs of abuse and neglect.
Safe recruitment practices were followed and appropriate checks had been undertaken which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.
Staff were supported to provide appropriate care to people because they were trained, supervised and appraised.
Where people were unable to make decisions about their care, staff were guided by the principles of the Mental Capacity Act (MCA) 2005.
Improvements had been made which helped to ensure that people received a nutritious diet.
Where necessary staff had worked effectively with a range of other healthcare professionals to help ensure that people’s health care needs were met.
People appeared relaxed and comfortable in the presence of the staff that were supporting them. Staff had a good knowledge and understanding of people which demonstrated they knew them well.
Meetings were held with people on a weekly basis and were an opportunity for them to make choices about how their care was provided.
People were encouraged to maintain relationships with their family and to make new friends through visiting the providers other homes nearby.
Staff demonstrated a good understanding of the meaning of dignity and how this encompassed all of the care provided to each person.
Improvements had been made to ensure that people were receiving care that was responsive to their wishes and preferences and allowed them to take part in activities of their choice.
People’s support plans were personalised and their preferences and choices were detailed throughout their care records.
People and staff were encouraged to give feedback about the service and this was used to drive improvements. Complaints policies and procedures were in place and were available in easy read formats.
The registered manager demonstrated a good understanding of all aspects of the home and the needs of people living there. Staff were positive about the leadership of the service. They felt listened to, respected and supported in their roles.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Deerhurst is a small residential home for up to three people with a learning disability and autism. The home is set in a quiet cul-de-sac location on a residential estate. It has a large open plan living area with a conservatory leading out into an enclosed garden surrounding the house which provides facilities for growing vegetables, playing games and a barbeque.
The home had recently appointed a new manager who was in the process of applying for their registration with the Care Quality Commission. 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 operations manager had managed the home during the absence of a manager. The new manager was under close supervision of the operations manager during their induction period.
Staff understood how to recognise the signs of abuse and how to report their concerns if they had any, including to external agencies such as CQC. There was a safeguarding policy in place and included relevant contact details and telephone numbers for reporting concerns.
Staff felt respected and listened to by the manager who involved them in the development of future plans. Training and support was in place to ensure staff were competent to carry out their role.
There was a positive and caring atmosphere in the home. Staff interacted with people with respect and promoted their independence.
Care plans were detailed and included a range of documents covering every aspect of a person’s care and support. The care plans were used in conjunction with person centred plans which included pictorial versions with photographs of activities. This helped to ensure that people’s wishes and skills were recorded along with their support needs. However, staffing was minimal and did not enable staff to provide responsive person centred support every day of the week. There were few opportunities for people to access activities outside of the home, especially at weekends and in the evenings when there was only one member of staff on duty.
There was evidence in care plans that the home had responded to behavioural and health needs and this had led to positive outcomes for people. However, people's weight management was not always monitored effectively and menus did not always reflect a balanced diet.
Risks to people had been appropriately identified and addressed in relation to people’s specific needs. Staff were aware of people’s individual risk assessments and knew how to mitigate the risks.
Medicines were stored safely and administered by staff who had been trained to do so. Staff gave people the time they needed and respected people’s dignity when giving their medicines.
People were asked for their consent before care or support was provided and where people did not have the capacity to consent, the provider acted in accordance with the Mental Capacity Act 2005. People’s mental capacity was assessed when specific decisions needed to be made, and were made in their best interest involving relevant people. The operations manager was aware of their responsibilities under the Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications for people using the service.
Systems were in place to assess and monitor the quality of the service although these were not always effective. Medicines audits had not identified some errors with the recording of medicines. Regular checks were carried out in relation to the environment and equipment, and procedures were in place to report any defects. Learning took place from incidents and accidents which were recorded, investigated and action taken to minimise the risk of re-occurrence.
We identified two breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. We have made two recommendations to the provider. You can see what action we have told the provider to take at the back of the full version of the report.
People were involved in making decisions about the care and support they received. One person told us, "I like going out in the car in the afternoons".
People experienced care and support that met their needs and protected their rights. Risks to people, staff and others were assessed and managed to ensure the safety of all parties.
People were supported to have adequate nutrition and hydration. One person we spoke with told us, "I really liked the lunch today".
There were enough qualified, experienced staff to meet the needs of the people living in the home.
The provider had systems in place to regularly check and monitor the quality of the service.
At this inspection we spoke with the manager, the operations manager, two members of staff and one person who lived in the home.
People's diversity, values and human rights were respected.
We found that care plans were detailed, person centred, accurately reflected people's needs and had been drawn up with their involvement where possible.
People were supported by staff that were supported to deliver care and treatment safely and to an appropriate standard.
One person we spoke with told us 'I really like living here'.
We observed that care workers and people living in the home were relaxed with each other, patient and sensitive. We saw care workers knew the people who lived in the home well and could anticipate their needs as required.
People who live at this home are treated with dignity and their privacy is generally upheld. However we have suggested that this could be improved.
People are supported to make choices about their individual lifestyles and their care and support needs.
People are provided with a healthy diet and are supported to make choices about what they eat.
The home is clean and tidy and good standards of hygiene are maintained throughout the home.
Staff are well trained and understand the need to keep people safe, whilst making sure that people are still able to live the life they choose.
People living at the home have access to a full range of healthcare support.