Archived: Dramsdon

Dramsdon is a residential care home providing personal care for up to five people with learning disabilities and/or autism. There were five people living there at the time of the inspection. Dramsdon is a bungalow set in large gardens, within the village of Shalbourne.

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

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.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when they were in the company of people.

People were supported by staff that were recruited through robust recruitment processes and had been trained effectively. Staff were aware of the different types of abuse and what action to take if there were concerns. There were sufficient members of staff on duty. Medicines were managed safely with safe systems in place to order, store, administer and dispose of medicines. Risks had been identified and risk management plans were detailed and reviewed.

People had their needs assessed which included health care needs. Support to access health care services was provided. 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.

Individual care plans were devised on how staff were to assist people to meet their needs. Communication needs were assessed and recorded in a communication passport. People were able to engage in social activities in their home and the local community. The service had built its own sensory lodge for people with sensory needs to aid their relaxation and de-escalate anxieties.

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

Rating at last inspection: Good, report published 03 April 2017.

Why we inspected: This was a planned inspection based on the previous rating.

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.

At the last inspection the service was rated good overall with one requires improvement in the Responsive domain. We found that people’s care and support plans did not always reflect people’s current needs and identify how care and support should be provided. This meant that people could be at risk of inconsistent care and/or not receiving the care and support they need. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook a full comprehensive inspection on 21 March 2017. After the previous inspection the provider wrote to us with an action plan of improvements that would be made and meet legal requirements in relation to the law. We found on this inspection the provider had taken all the steps to make the necessary improvements.

At this inspection we found the service had made all the necessary improvements and remained Good.

A registered manager was employed by the service and was present throughout our inspection. 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.

Care plans were personalised and contained information about the person’s preferences, likes, dislikes and what was important to them. Staff were knowledgeable about people’s care and support needs and acted in accordance with the guidance in their care plans. People had a range of activities they could be involved in. People were able to choose what activities they took part in and suggest others they would like to try.

People’s dignity, privacy and independence were promoted and people were treated with respect.

People were treated with compassion and kindness in their day to day care. Staff had a good understanding of people’s needs including how they expressed their individual needs and preferences.

People were protected against the risks of potential harm or abuse. Staff had received relevant training and understood their roles and responsibilities in relation to safeguarding people from abuse and harm.

Risks to people and their safety had been identified and actions taken to minimise these. Risk management plans were in place to ensure people received safe and appropriate care.

People’s medicines were managed safely. People’s health care needs were managed effectively.

People were supported to have a meal of their choice by organised and attentive staff.

Procedures were in place for the registered manager to monitor, investigate and respond to complaints in an effective way.

People were supported by sufficient staff with the right skills and knowledge to meet their individual needs. Safe recruitment practices were followed to ensure staff were of good character and suitable for their role.

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 were quality assurance systems in place which enabled the provider and registered manager to assess, monitor and improve the quality and safety of the service people received.

Further information is in the detailed findings below.

People were relaxed in their surroundings and looked well supported. Staff interacted with people in a friendly manner and were attentive to their needs. People were able to participate in varied social activities in relation to their individual needs and preferences. There was an emphasis on people receiving healthy, balanced meals of their choice.

The home was homely, clean and safe. Bedrooms were personalised and reflected people's individual interests and preferences. Systems such as clear procedures, audits and staff training were in place to minimise the risk of infection.

The staff team were committed, well supported and trained to do their job effectively. Many staff had worked at the home for many years and knew people well.

People had detailed support plans, which identified their needs and the support they required. Other records demonstrated a range of management systems within the home. Records were up to date, well written, organised and stored appropriately.

We saw staff and people in the home were at ease with each other and communicated successfully in many ways. We saw staff provided patient and gentle care. Each person had a health action plan, which was up to date. They received annual health checks from a GP who knew them. Person centred plans enabled people to have goals for each year, such as tailored holiday plans.

When we visited in February 2012 we found written records did not accurately reflect the care people received. This time we found record keeping supported and reflected people's experience of care and support.

Staff we spoke with understood how they would recognise signs of possible abuse and how to report concerns. A rota showed the provider made a manager available on call out of office hours.

Staffing needs were kept under review. Shift timings overlapped to give staff time for good quality handovers of information. The people in the home received consistent care from experienced staff who knew them well.

Care plans, individual goals, health checks and fire safety procedures were reviewed in a planned and timely way. However, when a person had moved in, the home had not worked out an evacuation plan for them as a priority.