Archived: Denmark Street

Denmark Street is a care home which provides residential care for up to five people who are living with a learning disability. At the time of our inspection five people were using the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures 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 or autism to live meaningful lives that include control, choice, and independence. People using the service 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

The registered manager and staff consistently demonstrated they valued and respected the people who used the service. The staff were passionate about supporting people to engage in meaningful activities and actively assisted them to develop their independent living skills. The staff team had been trained to use positive behaviour support (PBS) and had fully implemented these techniques. Staff found this approach greatly reduced individual’s distress and enhanced people’s quality of life.

We found staff were committed to delivering a service which was person-centred. 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 policies and systems in the service supported this practice.

Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately and lessons were learnt, which helped to keep people safe. People's health needs were thoroughly assessed. Staff actively promoted equality and diversity within the home.

Staff supported people to manage their healthcare needs and promoted their wellbeing. When necessary, external professionals were involved in individuals care. The staff supported people to eat varied appetizing meals. Medicine was administered in a safe manner.

Thorough checks were completed prior to staff being employed to work at the service. Staff had received appropriate training and supervision. The provider had enabled staff to access a varied and extensive range of condition specific training. The registered manager and staff had found the range of training they received assisted them to significantly improve people’s quality of life.

People’s voices were of paramount importance in the service. The registered manager understood how to investigate and resolve complaints.

The service was well run. Systems were in place, which effectively monitored how the service operated and ensured staff delivered appropriate care and treatment.

For more details, please see the full report which is on CQC website at www.cqc.org.uk

Rating at last inspection

Good (report published 4 April 2017).

Why we inspected

This was a planned inspection based on the rating at the last inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Denmark Street provides accommodation and personal care for up to five people with a learning disability and / or mental health needs. There are also two supported living services, where people receive personal care within their own home. There were eight people using these services on the day of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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.

People using the service told us they felt safe and were well cared for. Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe.

The accommodation provided was suitably adapted for the people who lived there. The building was safe, clean and well maintained. Minor maintenance items were highlighted to the registered manager to resolve. Risks associated with the building and in people’s own home’s, along with working practices were assessed and steps taken to reduce the likelihood of harm occurring.

We observed staff acted in a courteous, professional and safe manner when supporting people. Staffing levels were sufficient to safely meet people’s needs. The provider had a system to ensure new staff were subject to thorough recruitment checks.

Medicines, including topical medicines (creams applied to the skin) were safely managed.

Arrangements were in place to assess people’s mental capacity and identify if decisions needed to be taken on their behalf in their best interests. People’s mental capacity was considered through relevant areas of care, such as with decisions about finances, medicines and supervision when outside the home. Staff sought people’s consent before providing care.

Staff had completed safety and care related training relevant to their roles and the needs of people using the service. Further training was planned to ensure their skills and knowledge were up to date. Staff said they were well supported by the registered manager. Staff performance was supervised and assessed.

People’s nutritional and hydration (eating and drinking) status was assessed and plans of care put in place where support was needed. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly. People were provided with assistance to access healthcare services.

Staff displayed an attentive, caring and supportive attitude. We observed staff interacted positively with people. We saw that staff treated people with respect and explained clearly to us how privacy, dignity and confidentiality were maintained. Staff were able to communicate effectively with the people using the Denmark Street services.

Activities were offered on a group and one to one basis. Staff worked collaboratively with local day care services or accessed alternative funding to offer additional activities. Staff understood the needs of people and care plans and associated documentation were clear and person centred.

People using the service and staff spoke well of the registered manager and their leadership. Systems were in place to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from the care provider. Several incidents had not been notified to the Care Quality Commission (CQC) in line with legal requirements. Where incidents are not notified to CQC the rating for that key question is limited to inadequate or requires improvement. We wrote to the registered manager about this.