Danescourt

Updated 3 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 26 October 2017 and was unannounced.

Before the inspection, we reviewed the information we held about the service, which included incident notifications they had sent us, a recent registration application and statement of purpose for the service. We used information the registered provider sent us in their Provider Information Return (PIR). This is information we require registered providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We also contacted the local clinical commissioning group, who were the commissioners of the service, and Healthwatch for their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We spoke with the two people who used the service and observed the care and support they received in communal areas. We did not use the Short Observational Framework for Inspection (SOFI) as people told us what they thought of the service. SOFI is a way of observing care to help us understand the experience of people who cannot talk with us. We spoke with two relatives who were visiting on the day of the inspection.

We spoke with five staff, the manager and the service manager. We reviewed a range of records about the two people’s care and support and how the service was managed. These included the assessments and care and support plans, as well as the day to day records for the people who used the service. We saw how people’s medication was managed, including the storage and records kept. We also looked at staff records and at the quality assurance systems that were in place.

Updated 3 January 2018

We carried out this unannounced inspection on 26 October 2017. The inspection team consisted of one adult social care inspector and one hospitals (mental health) inspector. At the time of the inspection there were two people using the service.

Our last inspection of this service took place in April 2014. No breaches of legal requirements were identified and the service was rated Good. The rating was not published, because the service was inspected as part of first testing phase for the new inspection process CQC was introducing at that time.

At the time of this inspection Danescourt was registered to provide accommodation and care for up to eight people with learning disabilities. The service had been dormant for a long period and had been redesigned to provide a specialist five bedded service for male service users, transferring from forensic hospital placements. The service re-opened in May 2017. At the time of the inspection there were two people using the service.

The service had a manager, who had been employed by the trust, managing similar services for several years and who had run the home since Danescourt had reopened. They had applied to be registered with CQC. 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 and associated Regulations about how the service is run.

People said they felt safe and the staff we spoke with had a clear understanding of safeguarding people from abuse, and of what action they would take if they suspected abuse. There was a policy about whistle blowing and the manager told us staff were supported to question practice and whistle blowers were protected.

Care and support was planned and delivered in a way that ensured people were safe. The individual plans we looked at included risk assessments which identified any risk associated with people’s lifestyles, care and support. Although there was room to improve some written records.

People’s medicines were well managed.

We found there were enough staff with the right skills, knowledge and experience to meet people’s needs.

Staff were provided with appropriate training to help them meet people’s needs.

The service was meeting the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) and the staff we spoke with were aware of the Act. However, there was a need to further develop some risk assessments.

People were supported to maintain a balanced diet. The people we spoke with told us they liked the food and were involved in choosing and planning their menus, shopping and cooking their meals.

People were supported to maintain good health, have access to healthcare services and received on-going healthcare support. They received support from other professionals and healthcare services when required.

People’s needs were assessed and care and support was planned and delivered in line with their individual support plans. We saw staff were aware of people’s needs and the best ways to support them, and there was an emphasis on maintaining and increasing people’s independence.

The manager and all the staff we spoke with and saw supporting people had a caring approach and treated people with respect and dignity.

The service was for people with challenging needs and behaviour and staff successfully provided a very positive and calm atmosphere, and were very person centred and responsive in their approach.

People’s individual plans included information about their family and others who were important to them and they were supported to maintain contact. We saw that people took part in lots of activities and events in the home and in the local community and that this depended on the choices and individual interests of each person.

The service had a complaints procedure and people knew how to raise concerns. The procedure was available in an ‘easy read’ version.

The Trust management team had systems in place to assess and monitor the quality of the service at Danescourt and to continually review safeguarding concerns, accidents and incidents. Where action plans were in place to make improvements, these were monitored to make sure they were delivered.

The Trust sent out satisfaction surveys to stakeholders for them to comment on their experience of the service provided.

Staff said communication in the home was very good and they felt able to talk to the managers' and make suggestions. There were meetings for people who used the service and staff where they could share ideas.