Dawson House

About the service

Dawson House is a ‘care home’ that provides care and support for up to 7 people. All the people who live at Dawson House have a learning disability or autistic spectrum disorder. There were 7 people living at the home during the inspection. The service had 7 ensuite bedrooms on the ground and 1st floor. The 1st floor rooms were accessible by stairs. There was a modern kitchen diner, 2 communal lounges and a well-maintained garden.

CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

People received a service that was safe for them to live and staff to work in. Regular reviews took place of the quality of the service, and improvements made to ensure people’s care and support needs were met. This was in a manner that was best suited to them. There were well-established working partnerships that promoted people’s participation and reduced their danger of social isolation.

Right Care

The provider appropriately recruited, and trained staff in sufficient numbers to support people to live safely, whilst enjoying their lives. Risks to people and staff were identified, assessed, monitored, and reviewed. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. Trained staff safely administered people’s medicines.

Right culture

The provider had a culture that was positive, open, and honest with a leadership and management that was clearly identifiable and transparent. Staff were aware of and followed the provider’s vision and values which were clearly defined. Staff knew their responsibilities, accountability and were happy to take responsibility and report any concerns that might arise.

Rating at last inspection

The last rating for this service was Good (published 12 January 2018).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide a good, rated service for people.

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 overall rating for the service remains Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dawson House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

All visitors to the service were screened for symptoms of COVID-19 before being allowed to enter the home. Personal Protective Equipment (PPE) was available for visitors to wear should they need it and signs were in place giving clear instructions to help limit the spread of infection.

People were supported to maintain relationships with people who were important to them. The garden and outside areas were utilised when the weather allowed. When visits were restricted staff used alternative methods to help people maintain social contact with their family.

People who had tested positive for COVID-19 or were showing symptoms were isolated in their rooms. Staff had the time to engage with people individually when they needed extra support. People’s routines were important to them and staff aimed to keep these in place to help reduce people’s worries or anxiety. People were given additional 1-1 time with staff and activities were provided in people’s rooms to help reduce the risk of social isolation.

Staff had been trained in current IPC guidance and the use of PPE. Staff were wearing their PPE when we inspected and there were separate designated areas for donning and doffing. The service was clean and hygienic, and an enhanced cleaning schedule was in place. Furniture had been moved and surfaces cleared to encourage social distancing and help with the cleaning of high touch areas.

The staff team were confident in instigating full infection control measures when people showed symptoms or were tested positive for COVID-19. The registered manager was isolating at home for a time during the outbreak. The provider had been available for additional support and the staff team stepped up to make sure people remained safe. The registered manager told us, “While I was off, they [staff] knew what to do. I was so impressed with them…I could not praise them enough.”

Heathcotes, Dawson House, provides 24-hour residential care for adults with learning disabilities, autism and associated challenging behaviour. The service had seven en-suite bedrooms on the ground and first floor. The first floor rooms were accessible by stairs. There was a modern kitchen diner, two communal lounges and a well-maintained garden.

A registered manager was in post at the time of our inspection. 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.

People indicated they felt safe living at Dawson House and relatives we spoke with confirmed this. There were enough staff on duty to keep people safe and staff knew the systems and processes in place to protect people from harm. People and staff were encouraged to raise concerns and staff told us they felt they were listened to.

Staff protected people from risk while minimising restrictions on people’s choice and control. This gave people the independence and freedom to try and experience new things while still being safe.

People had good continuity of care by a staff team who knew people well. Staff attended training which gave them the knowledge and skills to support people effectively. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Medicines were managed safely and people received their medicines when they needed it. The service was undergoing a plan of essential maintenance and risks to people during this period were assessed and managed to help ensure people were kept safe.

People were supported to take part in interests and activities they enjoyed.

People were encouraged to make health choices about their food and supported to have sufficient amounts to eat and drink. Risks associated to people’s diet had been identified and staff knew what to do to manage this risk. Staff supported people to access the healthcare services they needed to maintain their health and referred people to specialist support when necessary.

Care records were focused on each person and gave a complete picture of the individual including their physical, mental, emotional and social needs. Staff understood the best ways to communicate with people and used a range of techniques including visual systems to help people communicate their needs. Recognised techniques were used to enable staff to support people as individuals when they became upset or anxious so people experienced positive outcomes in terms of managing behaviour which challenged others.

The provider listened to and acted on complaints. Information was available for people and their relatives to make a complaint and relatives were confident the registered manager would respond appropriately if they raised any concerns.

Leadership was visible across the service and the registered manager, regional manager and staff had a good understanding of their roles and responsibilities. The provider had a range of audits in place to assess, monitor and drive improvement. When things had gone wrong lessons were learned and this was shared across the service.