Dane House

Dane House is a residential care home providing accommodation and personal care to 6 people at the time of the inspection. The service can support up to 6 people.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support: Some risks to people were not documented and assessed to ensure staff had all the information they needed. People were supported by staff who knew them well and maximised their opportunities for independence. A relative said, “We are very lucky to have found this place,” a person told us, “I’m happy here.” 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 supported people to make decisions themselves and communicated with people in ways that met their needs. People were supported to maintain contact with people who were important to them. They used local community services and were supported to access health care services.

Right Care: People were receiving person centred care from staff who were kind and caring. People and their relatives spoke positively about the staff. One person told us the staff were kind and said, “They are all my favourites.” The staff respected and promoted people's dignity, privacy and human rights. People were able to access their bedrooms independently which promoted their privacy and dignity. Staff were appropriately trained and had the skills to support people’s individual needs, to communicate effectively and to support their safety.

Right Culture: The culture of the service was positive and open, staff described being well supported in their roles. Staff understood people’s sensory needs and used positive behaviour support techniques effectively to support people when they experienced episodes of distress. The registered manager and provider recognised where practice needed to improve and took immediate actions to address shortfalls in risk assessments, care plans and systems for monitoring quality.

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 24 July 2021) and there was a breach of regulation. 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 was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 4 June 2021. A breach of legal requirements was found. The provider completed and action plan after the last inspection to show what they would do and by when to improve the need for consent. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective 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 those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained as requires improvement. 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 Dane 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.

Dane House is a care home providing accommodation and personal care for up to six people living with a learning disability, including autism. At the time of inspection, the service was supporting six people.

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

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The policies and systems in the service had not always supported this practice. People’s consent had not been considered regarding the practice of using locks on bedroom doors. The registered manager took immediate action to address the concerns. This included ensuring Best Interest meetings had been documented and Deprivation of Liberty Safeguards (DoLS) authorisations reviewed with the local authority to include this practice. The provider’s oversight and monitoring systems had not identified this concern.

We have identified one breach in relation to gaining consent in accordance with best practice at this inspection.

This was a newly registered service, and many people had moved in during the COVID-19 pandemic. This has had an impact on how much relatives could be involved with the transition of their loved ones from previous care settings. Relatives told us they were confident that people were safe and supported by a knowledgeable staff team. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.

To ensure that people received their care safely, risk assessments were completed. People had the opportunity to take part in activities which interested them and promoted their independence. People had detailed Positive Behaviour Support (PBS) plans which ensured staff had access to strategies and guidance to keep people safe.

Medicines were managed safely, and staff had a good knowledge of the medicine systems and procedures. There were adequate numbers of staff to meet people’s needs.

People were supported to maintain their health and wellbeing. People enjoyed the meals provided and were offered foods to encourage a varied diet. Menus were provided in a pictorial form and people told us how they enjoyed the takeaway night on Fridays.

We observed people and staff had developed positive relationships, and staff treated people with compassion, kindness and respect. One relative told us how their loved one had, “Settled in much quicker than expected” and another said they felt their loved one was “supported quite well there.”.

People were encouraged to engage in activities and some accessed day services. People's communication needs were fully considered, and they had access to information that was accessible and meaningful to them. People's care plans were person-centred and captured their likes, dislikes and preferences.

The registered manager monitored the quality of the service and used feedback from people and staff to identify improvements and act on them. The service worked in partnership with other agencies to ensure quality of care across all levels. People, relatives and staff were encouraged to provide feedback about the service. The service had quality assurance systems in place, which were used to good effect and to continuously improve on the quality of the care provided.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

Right support:

• Support was person centred, policies and procedures were in line with current best practice. The service worked collaboratively with family, professionals and commissioners to ensure people were supported to be involved in their communities in a meaningful way.

• The provider did not always consider practices that may be potentially restrictive to people. The provider had taken immediate action to address this and as a result ensured people’s rights had been considered; this minimised the impact this measure had on the person’s choices.

Right care:

• Care was provided by a skilled staff team who demonstrated awareness of the person’s rights to privacy and dignity. Records relating to care were detailed and provided staff with strategies and guidance to support people safely.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

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

This service was registered with us on 25/10/2019 and this is the first inspection.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service about the use of locks on bedroom doors as potential restrictive practices. A decision was made for us to inspect and examine those risks. We inspected and found there was a concern with how consent had been obtained for this practice, we widened the scope of the inspection to complete a comprehensive inspection.

We have found evidence that the provider needs to make improvements. Please see the effective section of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Dane House is a care home providing accommodation and personal care for up to six people living with a learning disability, including autism. At the time of inspection the service was supporting six people.

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

People were engaged in activities throughout various areas of the service. Staff were available to support people with their chosen activity. Staff demonstrated a good understanding of the individual needs of people and how that may impact on Infection Prevention and Control (IPC) measures. The records showed a good level of understanding of the individual needs of the people.

Relatives told us staff had worked well to get to know people that had recently moved into the new service. The Covid-19 pandemic and outbreak had affected visits to the service. However, relatives told us they were reassured that the staff and registered manager were doing a good job as their relative appeared happy, telling us “we were lucky to have a placement here” another relative told us “ staff listened to professionals “ who understood the persons complex care needs and “its nice to feel confident that [person] was safe and well looked after”.

Staff confirmed that they had received training and ongoing competence assessment on IPC measures and the use of Personal Protective Equipment (PPE). Staff told us that they had felt supported by the registered manager and the organisation, one staff member noted how positive it was to see the managers “working on the floor” alongside others in the team.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The inspection looked at only part of a key question focused on Infection Prevention and Control. The information gathered from observations with people, discussions with relatives and staff, review of records pertinent to this inspection evidenced this service’s personalised approach. The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and

Independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human

Rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people

using services lead confident, inclusive and empowered lives

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

This service was registered with us on 24 October 2019 and this is the first inspection.

Why we inspected

As part of CQC's response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 23 November 2020 and was unannounced.

CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from any previous inspection. This is because they do not assess all areas of a key question.

Follow up

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