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Archived: Dunsland Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 16 July 2020

About the service

Dunsland is a residential care home providing personal care and support for up to 14 people aged 18 years and over living with learning disabilities, autism, physical and mental healthcare needs. At the time of the inspection, 10 people were living at the service.

The service has not been developed and designed fully in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The service was a large home, bigger than most domestic style properties, and larger than current best practice guidance for people with learning disabilities and autism.

The size of the service was having a negative impact on some of the people due to building design and layout, and the number of people sharing communal areas of the service. Not all the principles had been applied to the service provided, to ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that includes having control, choice, and independence. People using the service should also receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were not being supported by consistently caring and suitably trained staff. This was confirmed by our observations and feedback received from people living at the service.

We identified ongoing significant environmental risks and concerns impacting on the standards of safe care being provided. People living at the service were not always able to assess risks independently and relied on staff for support. Leadership and governance arrangements within the service had further deteriorated since the last two inspections.

We identified new and repeated breaches of regulation and the provider, in the absence of a registered manager, was not meeting their legal regulatory responsibilities to ensure people received good standards of care or that sufficient action was being taken to address shortfalls from the last two inspections.

People were not always supported to have maximum choice and control of their lives. We observed examples of restrictive practice. Staff did not always support them in the least restrictive way possible; policies and systems in the service were not followed to support good practice or reflecting the principles and values of Registering the Right Support.

We continued to identify concerns regarding the levels of activities and social stimulation for each person. This had less impact on those people able to access the community independently. The service had not implemented recommendations made in the last comprehensive inspection report regarding people’s end of life care planning, and care records did not consistently contain protected characteristics in relation to personal choice and preferences.

The care environment remained unclean, with ongoing concerns regarding infection, prevention and control risks to people. We continued to identify concerns regarding people’s medicines management at the service.

Rating at last inspection

Dunsland was previously inspected 09 May 2019 and rated as Inadequate overall, with breaches of regulation and the service was placed into special measures. The report was published 27 August 2019.

A focussed inspection visit looking at safe and well-led, in response to concerns received was completed 17 October 2019, the service remained rated as Inadequate, with breaches of regulation and remained placed in special measures. The report was published 22 November 2019.

This will be the third, consecutive inspection where the service has been rated inadequate and remained in special measures.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified repeated breaches of regulation in relation

Inspection areas

Safe

Inadequate

Updated 16 July 2020

The service was not safe.

Details are in our safe findings below.

Effective

Inadequate

Updated 16 July 2020

The service was not effective.

Details are in our effective findings below.

Caring

Inadequate

Updated 16 July 2020

The service was not caring.

Details are in our caring findings below.

Responsive

Inadequate

Updated 16 July 2020

The service was not responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 16 July 2020

The service was not well-led.

Details are in our well-Led findings below.