Archived: Dashwood

We carried out an unannounced inspection at Dashwood on 28 August 2018. The service had a registered manager in place. 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 were safe as staff knew the correct procedures to follow if they considered someone was at risk of harm or abuse. Staff had received appropriate safeguarding training and there were policies and procedures in place to follow in case of an allegation of abuse. The provider had safe recruitment procedures in place and conducted background checks to ensure staff were suitable for their roles. Staffing numbers and shifts were managed to suit people's needs so that people received their care when they needed and wanted it.

Risks to people were identified and plans put in place to minimise these risks. Guidance was in place for staff so that they could mitigate risk, and support people to take sensible risks as safely as possible. People received their prescribed medicines and were encouraged to have as much independence to manage medicines themselves safely.

People were fully involved in the development of their care planning along with health and social care professionals. Staff had access to information, support and training they needed to provide people with satisfactory care. The provider’s training was designed to meet the needs of people using the service.

People were supported to maintain their health and were referred for specialist advice as required. Staff worked with local social and health care professionals and referrals for specialist advice were submitted in a timely manner. People's nutritional needs were met and people were supported to maintain a balanced diet.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There was clear guidance for staff on how to meet people’s individual needs and support them to achieve their goals. Staff treated people with kindness, respect and promoted people's right to privacy.

People were provided with information about how to make a complaint and these were managed in accordance with the provider's complaints policy. The registered provider had informed the CQC of all notifiable incidents.

The registered manager was aware of the values and vision of the organisation and to ensure these were implemented into the service to ensure people achieved positive outcomes. The provider ensured guidance and best practice was promoted by engaging in national forums. There were quality assurance systems in place which monitored the service, identified potential areas for improvement and actions were taken to improve these.

We inspected Dashwood on 20 July 2016. This was an unannounced inspection.

Dashwood is a supported living service that provides personal care and support to people with learning disabilities. Supported living is where people live in their own home and receive care and/or support in order to promote their independence. The care received is regulated by the Care Quality Commission (CQC), but the accommodation is not. It aims to enable the person to be as independent as possible, The service covers the Banbury area and currently provides support to seven people living at Dashwood. They also provide an outreach service to 14 people and this is run from an office in Dashwood Court.

There was no registered manager at the service at the time of our inspection. 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. The service had not had a registered manager since January 2015. The CQC received an application from the manager in April 2016 to become the registered manager. However, the outcome of this was not known at the time of the inspection.

People and their relatives said they felt safe. The provider had policies and procedures in place in relation to safeguarding adults. Staff had received training and understood how to report concerns. People’s care records contained risk assessments. These identified any risks related to each person and described the measures and interventions to be taken to manage risks. There were sufficient staff to support people safely. Staff had been checked before they started working for the service to ensure they were suitable to work with vulnerable adults. Medicines were managed in a safe way. We looked at how records were kept and spoke with the manager about how staff were trained to administer medication and we found that the medication administration process was safe.

Staff training records showed staff were supported to maintain and develop their skills through training and development opportunities. Staff we spoke with confirmed they attended a range of learning opportunities. They told us they had regular supervisions with the manager, where they had the opportunity to discuss their care practice and identify further training needs.

People told us they were involved in all day to day decisions about their care and records evidenced their consent about support they received. Staff had received training about the Mental Capacity Act 2005 (MCA) to ensure people were supported in line with the principles of MCA. However decisions were not always documented appropriately.

People were supported to shop and maintain a healthy diet. Care records showed people’s health was monitored and referrals were made to other health care professionals where necessary for example, GP and mental health team.

People felt that the staff were caring and helpful. People told us they were treated with dignity and respect by staff.

People had been assessed to see what support they required before moving to the service. Care plans were written clearly and in a person centred way. Care plans included personal histories and described individual care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the care staff and the registered manager.

People were encouraged to plan and participate in activities that were personalised and meaningful to them. Some people were in employment. We saw evidence of other activities such as social groups and people being supported to be involved in their local community both with support and independently. People were encouraged to take part in meetings to discuss what changes they wanted or to suggest new activities or events.

We saw a complaints procedure was in place and this provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed it.

The service had not always notified the CQC about incidents that affected the service. We found that the service had been regularly reviewed through a range of internal and external audits. People, relatives and staff said management were approachable.

Everyone we spoke with was happy with the service and support provided, one person said, 'it's fantastic here, and everyone is friendly and kind'. Another person said, 'out of 10, I give it 12, superb'. One person's relative told us, 'it is perfect for them [their relative]; they have become much more confident since being supported by the service'.

We found that people were respected and involved in day to day decisions and decisions about their care. The staff responded in accordance with the choices people made. People had their own 'service meeting' and involvement was encouraged in all areas of the service. This meant that people were being supported to live as independently as possible.

People were involved as much as practically possible in the planning of their own care and staff were aware of the plans and people's needs. Care files contained documents that were person centred and regularly reviewed.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People who used the service felt safe and staff we spoke with understood the procedures in place to keep people safe.

Care staff had regular supervision to support the performance and development. Care staff were well inducted into the service and offered training to meet the needs of people they supported.

We found there was an effective system to regularly assess and monitor the quality of service that people received. Regular daily, weekly and monthly checks of the service ensured people received quality and safe care. This was due to up to date records and a well maintained environment. People's views were sought and responded to effectively and people felt able to raise concerns when they needed to. Incident and accidents were recorded and the service analysed these occurrences to improve the safety of people and the service as a whole.