Archived: Darmel Respite

Darmel Respite is a small respite service, caring for one person at a time who may have a physical disability or progressive illness. The registered provider manages the service and is the only member of staff.

A Disclosure and Barring Service (DBS) application had been completed prior to the provider commencing operation of the service. The DBS supports the safe employment of staff caring for vulnerable people by carrying out criminal record checks and ensuring they are not barred from caring for vulnerable people.

A detailed pre admission assessment was carried out to ensure that the provider was aware of all safety requirements and equipment that would need to be in place to ensure the safety of people who used the service. Individual risk assessments were carried out and there were resources for example, skin integrity or nutrition assessments, to use should any further risks be identified during their stay.

A person who used the service and their families told us that the provider was able to meet the needs of people staying at Darmel respite very well. The provider had contingency plans in place to enable additional staff to support her should the need arise.

There were safe procedures in place for the storage and administration of medicines. People were supported to maintain their independence and manage their own medicines where this was appropriate.

The provider had carried out a range to training to enable her to care for people safely, including moving and handling, and the safe management of medicines. She had also carried out self-directed learning to find out more about particular health conditions. People and their relatives told us that the provider was highly skilled and very effective in her role as a “carer”.

People were consulted about their care, and before each visit to the service, the provider visited people to ensure that they consented to their stay and the care and support that would be provided. We saw that people had signed to confirm their agreement.

People were supported to eat and drink and any special dietary considerations were catered for. The provider had previous experience as a cook, and was happy to provide meals based on the preferences of people who used the service. She had knowledge of special dietary requirements and foods to avoid in certain health conditions.

There was access to healthcare services if required, but this was not usually necessary during a respite stay. The provider escorted people to pre-arranged hospital appointments, and ensured that she had all of the necessary up to date information regarding health needs. Care plans were in place and contained the required amount of detail.

The service consisted of a purpose built unit which was attached to the provider’s home. People could choose to remain in their own accommodation, or join the provider and their family in the family home. The building was wheelchair accessible and people were able to use an alternative entrance to the family for their privacy. The people we spoke to liked the fact that they were able to be included in the activities of the family if they chose to do so, and the kitchen was a favourite place for people to sit and talk or carry out activities. There was an en suite wet room with ample space to allow people to be supported. The provider was aware of the importance of maintaining dignity, and was very sensitive and discreet in her communication about this.

We received very positive feedback about the service from people and their relatives. They all told us that the provider was very kind and had a natural gift for caring. They particularly liked the one to one attention they received from the provider and her ability to put people at ease and to make them feel at home. People were included in all aspects of their care and the provider took pictures of the service and provided information to people and their families before they used the service. People were given choices about all aspects of their stay and the provider went out of her way to make the transition between home and the service as seamless as possible.

The provider regularly sought the views of people who used the service and their families. There was a satisfaction survey on the website which people were encouraged to complete, and the provider was introducing paper versions of this to ensure they were accessible to everyone who used the service. There were no plans to expand the service as the provider was keen to ensure it remained as homely and responsive as possible, but told us that she was always keen to learn new skills to improve upon any aspect of the service. People we spoke to told us they could not think of anything that could be improved and said they were very happy with the quality of the service provided.

People who used the service had capacity, and the provider was aware of the requirements of the Mental Capacity Act 2005 and appropriate training had been completed.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found '

Is the service caring?

People were supported directly by the provider. We saw that the provider was aware of people's individual needs, supported them to be as independent as possible and was kind and attentive when dealing with the person in their care.

The provider carried out assessments before people used the service and gathered information about what they liked or disliked. One person's relative told us, '(The provider) discussed things over the telephone and then visited to see the set up.'

Activities were tailored to meet the individual needs of people accessing the care. The person using the service on the day of our inspection told us they were happy with the care, that the food was good and that they felt part of the family when they visited.

Is the service responsive?

People's needs were assessed prior to them accessing the service and they were invited to visit the home to see if they were happy with the facilities and service offered. We found that people's individual needs were considered, such as food likes and dislikes. Where people had additional needs, such as requiring extra help with moving and handling then these were achieved by the use of outside agency support.

Where there was any concern about the health and welfare of the individual using the service then professional advice and support was sought in a timely manner.

We saw people were able to join in activities with the provider's family, but equally could retire to their own room if they wished to sit quietly or be alone. A range of activities were also provided based on individual needs. The person using the service at the time of our inspection said that if there was anything he wanted then it was provided. A relative we spoke with told us, 'I am very impressed with the care and attention that my wife got there. I could not fault the care package in anyway.'

People using the service were able to maintain contact with friends and relatives during their stay and facilities were available for relatives to stay at the home if they wished to do so.

Is the service safe?

We witnessed that the person using the service on the day of our inspection was treated respectfully and their dignity was maintained when care was delivered or their needs supported.

Systems were in place to ensure the environment was safe. The facilities had been developed to ensure that people could access areas throughout the home and the garden. There were regular checks on the smoke alarms throughout building and there was information available about how to exit the building in the event of an emergency.

Where additional staffing was required this was provided to ensure that care was delivered safely; for example, when addition support was required to help move the person using the service.

The provider had experience in the field of care provision and had undertaken a range of training, including food hygiene.

Is the service effective?

People who used the service were assessed prior to them using the facilities and services were provided in line with their assessed needs. Where necessary dietary requirements or particular likes and dislikes were catered for. The person using the service on the day of our inspection told us that they were happy with the service and had used it on several occasions.

Facilities within the home had been adapted to ensure that people could access a range of areas and were welcoming and homely. People could access the service for a variety of periods from a few hours to longer periods of stay, to suit their particular needs. One relative had formally expressed satisfaction with the care provided.

The provider had a range of experience and training to support them in delivering effective care and support.

Is the service well led?

The provider had a strong ethos on delivering individually tailored, high quality care based on their own experiences. Services were based around a highly personal service that welcomed and encouraged people to be part of a family environment; supporting both their care and social needs.

Care was provided on a one to one basis meaning that people's individual needs were always at the forefront of care delivery.

Where additional help and advice was required the provider sought professional input and support to ensure the person's welfare and health were maintained.