Dannsa House

About the service

Dannsa House is a residential care home registered to provide personal and nursing care for up to 5 people. The service provides support to people who have learning disabilities and/or autistic people. Nursing care was not being provided at this care home. At the time of our inspection there were 4 people using the service.

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

Right Support

The staff supported people to have the maximum possible choice and control over their own lives. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community.

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.

Right Care

Staff understood and responded to people’s individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them. People’s care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life.

Right Culture

Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them were involved in planning their care. Staff valued and acted upon people’s views. The manager ensured risks of a closed culture were minimised so that people received support based on transparency, respect, and inclusivity.

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 last rating for this service was Requires Improvement (published 18 October 2022).

We also issued the provider with a Warning Notice in respect of staffing issues which required swift improvements. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider had complied with the requirements of the Warning Notice and was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also checked if the provider had followed their action plan and to confirm whether they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective, Responsive and Well-led which contain those requirements.

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.

For the Caring key question not inspected, we used the rating awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to 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 Dannsa 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.

About the service

Dannsa House is a residential care home registered to provide personal and nursing care to up to five people. The service provides support to people who have learning disabilities and/or autistic people. Nursing care was not being provided at this care home. At the time of our inspection there were four people using the service.

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

People’s basic care needs were met, but they were supported by staff who had not received specialist training necessary to enable them to effectively and safely meet their complex care and communication needs.

People received most of their care support from agency care staff due to the high number of staff vacancies at the care home. The provider used regular agency staff, but they had not received specialist training, or received supervision, and did not have their competency assessed by the provider.

People were not always supported to have maximum choice and control of their lives, due to the lack of specialist training received by staff. However, 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 told us they felt supported by their manager, but less so by the provider. The care home had good links with external healthcare professionals. The manager and staff understood their roles and were committed to providing person centred care for people.

People were protected from the risk of abuse and neglect. Care staff had received safeguarding training and the provider’s safeguarding policies and procedures supported this.

People’s individual risks were assessed, and the information was used to inform their care plans. People’s medicines were managed and administered safely. The care home environment was generally clean and homely.

Right Support

People were not always supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice. However, limitations due to the reliance on agency care staff and limited specialist training provided, increased the potential that people’s individual strengths would not be developed. This also increased the potential that people would not be effectively supported to have a fulfilling and meaningful everyday life. People were not always able to be supported by staff to pursue their individual interests outside of the care home. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced. The service gave people care and support in a safe, clean, well equipped, well-furnished and generally well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual basic physical care needs. Staff understood how to protect people from potential abuse. The service worked well with other agencies. Staff had training on how to recognise and report abuse and they knew how to apply it. People’s care, treatment and support plans reflected their range of needs, interests and aspirations.

Right Culture

Most staff knew people well and were responsive to their basic care needs. Staff placed people’s needs and rights at the heart of everything they did. People and those important to them were involved in planning their care. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

Rating at last inspection

The last rating for this service was Good (published 26 March 2020).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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.

We have found evidence that the provider needs to make improvements.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to staff training. We issued the provider with a Warning Notice in respect of this breach of regulation.

Follow up

We will continue to monitor information we receive about the service. We will reinspect the service to check if the provider has taken the necessary action to comply with the requirements of the Warning Notice.

We conducted an unannounced inspection at Dannsa House on 18 February 2020. Dannsa House provides personal care and accommodation for up to five people living with learning disabilities. It is one of a number of homes run by The Kisimul Group. The service is a large modern house situated in a quiet village location.

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 and/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:

People felt safe living at the service. Staff were trained in safeguarding and could spot the signs of abuse and knew who to report to if they suspected someone was at risk.

People were supported by sufficient numbers of staff who were competent, skilled and knew people well. Staff levels were monitored and increased to support people with appointments and activities when required. Safe staff recruitment checks were completed when staff commenced their employment.

The management, administration and storage of medicines was managed well, and people were receiving their prescribed medicines. Medication audits were carried out frequently so that if there were any errors, they were picked up promptly.

Best practice guidance in relation to infection prevention and control was followed and health and safety checks were completed on the environment and equipment.

Staff received comprehensive training and support in their role. This included specialist training specific to the needs of the people using the service. Staff were aware of the healthcare needs of people who they supported and knew how to refer to a healthcare professional if necessary.

People were encouraged to have choice at mealtimes and staff communicated in ways that were appropriate for people. People were supported with their health care needs and accessed external healthcare professionals and services. Information was shared with external healthcare agencies to support people to receive consistent care.

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.

People's care and support had been planned in partnership with them. People and their relatives were consulted and listened to about how their care would be delivered.

People’s privacy and dignity was respected, and their independence actively promoted.

People were supported with opportunities to pursue social activities, interests and hobbies. People were supported to identify and achieve personal goals. End of life wishes was being arranged with contributions from close relatives.

Staff had access to policies and procedures that reflected legislation and current best practice. The management team were enthusiastic and had a positive approach to developing the service and looked towards continued improvement.

Quality monitoring and audits were robust and monitored every aspect of the service. These were carried out by the registered manager and senior management. This ensured that if an area of the service required attention, this was done immediately as through the auditing, every aspect of the service was continually under scrutiny.

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 and/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.

Rating at last:

This service was registered with us on 25 February 2019 and this was the first inspection.

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

Why we inspected:

This was a planned inspection for this newly registered service.

Follow up:

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