We carried out a review of the data available to us about Derwent Cottage on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Derwent Cottage, you can give feedback on this service.
We found the following examples of good practice.
Everyone followed up to date government guidance when entering and leaving their home and when receiving visitors. Staff and people were tested regularly for COVID-19. Evidence of completion of the required vaccinations was maintained for staff.
The home was well maintained, the environment was clean and well managed. Staff had received training in Infection Prevention and Control and understood the requirements for the use of personal protective equipment to keep everyone safe.
People had risk assessments to support them to live safely under COVID-19.
Derwent Cottage is registered to provide care and accommodation for up to four people with profound learning disabilities and/or autism. At the time of our inspection four people were living at this service.
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 received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
People’s experience of using this service and what we found
The leadership and team working within this service was exceptional. This ensured everyone received high quality and personalised support. The history of this service showed the provider, registered manager and the staff team worked in partnership to continuously improve and this achieved the best outcomes for people. Everyone without exception, praised the leadership and compassionate approach within this service. Staff were responsive to people’s needs, whilst supporting them to learn new skills to improve their health and well-being. Health professionals described the service as; “Refreshing" and "The best I have experienced."
The leadership encouraged staff to approach people in a person-centred way, understand their needs and remove barriers to exceed expectations. People achieved positive outcomes through staff exploring and being innovative in the way they supported them. People’s independence was encouraged by staff that were creative in finding ways to enable people’s living skills to flourish. Activities, events and therapies were adapted to each person’s needs to support social inclusion and promote choice whilst considering people’s preferences.
Staff cared for people like they would their own family members. Relationships between people, staff and the registered manager were exceptionally proactive. People trusted staff that knew and understood them exceptionally well. Records and observations showed management and staff responded proactively to known risks to people and the aftercare with and without input from health professionals was taken above and beyond normal practices.
The service demonstrated the remarkable achievements made to improve people’s quality and experience of life. Relatives told us, “The service worked closely with teams of health professionals and in the wider organisation to look at ways to improve outcomes and support individual achievements. Step by step processes had been introduced, people had gained new skills, become settled in themselves and responded positively. Staff were self-aware and listened to people expressing themselves before considering the best way to support each person.
The service demonstrated positive outcomes for people which reflected the principles and values of Registering the Right Support. This included supporting people to make their own decisions and choices to maintain independence and control of their lives. People’s life experiences were improved by staff accessing the right support at the right time, to maintain positive outcomes for people’s health conditions. The service ensured people’s rights were upheld and advocated on their behalf when necessary. This meant people received timely care and support from health professionals and other agencies, which had a positive impact on their lives.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice. People and their relatives or representatives were fully involved in all aspects of their care. People’s aspirations were considered, and relatives involved in nurturing these achievements which encouraged people’s participation. The vision and values were embedded in the culture of the service, staff were committed and focused to deliver care that supported people to achieve their own goals and aspirations.
Staff knew the importance of asking for people’s consent before delivering care and support to them. Staff knew how people expressed themselves and were mindful to ensure they were settled and happy before proceeding.
The registered manager had a wealth of experience and exceptional leadership skills. The staff team communicated exceptionally well to deliver the best outcomes people could achieve. The registered manager was constantly encouraging staff to look at ways they could enhance people’s lives.
The registered manager and staff put people at the heart of everything they worked towards. The working relationships between people and staff were extremely productive and harmonious. Peoples well-being had significantly improved, some over a short period of time. This showed how the service succeeded in delivering high quality care and support in partnership with people.
Since the last inspection, the service had continued to review processes and introduce new initiatives to support achievements and people’s life skills and independence. Where positive outcomes had been achieved this practice was shared with other staff that managed services run by the same provider. The registered manager at this service took an active role in auditing and supporting other services to achieve outstanding ratings.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with, or who might have, mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. At the time of our inspection the service did not use restrictive intervention practices.
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 Outstanding (published 18 March 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.
There was a registered manager in post at the service. 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.
Derwent Cottages is a care home for four adults with a learning disability and/or autistic spectrum disorder. It is part of a group of services known as Voyage Care which is a UK wide organisation. The service is a family home over two floors. There is a lift to enable access to the first floor. Each person had their own bedroom and bathroom. There were four people living at the service at the time of the inspection.
Staff worked within the principles of the Mental Capacity Act in every aspect of their work with people. 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.
We saw that people were safe and a relative and professionals confirmed this. Staff had an excellent understanding of safeguarding and were aware of types of abuse and how to report incidents. They knew the people they supported extremely well which resulted in people feeling safe and behaving in a confident way around staff.
There were robust recruitment processes in place to assist the registered manager in making safe decisions about who they employed. Each person had one to one support. The registered manager chose to work two shifts a week which allowed them to maintain their relationship with people and to be able to supervise practice. They were usually supernumerary. This means they worked in addition to support staff.
Staff received a thorough induction when they started working at the service which gave them the skills and knowledge to care for people. This was based around the people who used the service. Staff then went on to complete further training relevant to their roles. They were supported through supervision and appraisal.
People’s medicines were managed safely. Staff had received specialist training in order to be able to administer emergency medicines for certain health conditions.
Risks to people’s health and safety had been identified and extremely detailed risk assessments and management plans were in place to guide staff. These were linked to well written and personalised care plans.
People’s nutritional needs were identified and supported by staff. Where further input was required by healthcare professionals the staff had requested referrals.
The environment supported people’s needs and their personal space reflected their preferences and personalities. Specialist equipment was checked regularly to ensure it was safe. Regular servicing of equipment and checks of services such as gas, electric and water took place.
We saw that people mattered to staff and staff respected their privacy and dignity. People’s preferences were taken account of when planning their care and they could choose how that care was delivered.
People’s care plans were extremely detailed and reflected the person’s needs exactly. Each area of the individual’s life had been examined and detailed records made about the way in which they liked to spend their days. This included social interactions and activity. People had activities they took part in that were individual to them. Where they had friends or family they were supported to maintain those relationships in a meaningful way.
No complaints had been received at this service since the last inspection. Compliments reflected our findings.
The quality of the service was assessed regularly and improvements made. Where there were concerns these were discussed and a lessons learned approach taken
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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The inspection was announced twenty four hours prior to our visit because we wanted to ensure that people were at home. When we inspected Derwent Cottages in June 2013 we did not ask for any improvements to be made.
Derwent Cottages is a small care home which provides accommodation and personal care for four people with learning disabilities or autistic spectrum disorder in the village of Seamer. The service is part of a company called Voyage 1 Limited. Derwent Cottages provide a service for younger adults and older people. The service has a vehicle for people to use to get out into the community. There were four people living at this service on the day of our inspection.
There is a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider
We found that this service was safe. Staff had developed positive relationships with people who used the service and were skilled at communicating with them. This meant that people were listened to and understood. An advocate, healthcare professionals and families said when asked that they all believed the service to be safe. Staff recognised different types of abuse and received training and updates to ensure that they followed good practice guidelines if they saw that someone was at risk of harm.
Medicines were managed safely and the risk of infection was minimised by practices followed by staff.
People at this service received care and support from people who were properly trained and supported which meant that the service was effective.
People who were unable to make their own decisions were protected because staff followed Mental Capacity Act 2005 guidance. Staff understood how to apply for an authorisation to deprive someone of their liberty if this was necessary and in their best interest.
People were supported to have enough to eat and drink and their environment was adapted to meet their needs in relation to areas such as moving and bathing. People had their own rooms and had chosen how they were decorated and furnished.
Staff were caring and compassionate. People were able to maintain contact with families with staff support and sometimes with the use of technology. Peoples care needs were recorded in detail. They had patient passports which contained relevant information in case they needed to visit a healthcare professional.
The service had no complaints in the last year and had made notifications as required to the Care Quality Commission.
Leadership at this service was demonstrated at all levels. The culture was open and transparent and people felt supported. The registered manager was knowledgeable and very proactive. They were committed to developing and improving the service.
We looked at the consideration given to nutrition and support with regard to people's dietary intake and found this to be considered and individualised.
The service had robust procedures in place for identifying and dealing with safeguarding and staff showed a good understanding of the correct ways to follow the processes in place.
We looked at the support mechanisms in place for staff, which were focussed on person centred working and reflective practices. Staff were given opportunities and support to allow them to develop professionally within their roles.
Quality assurance systems were in place for various elements of the service and these were used effectively. Paperwork and records were up to date, detailed and were stored and destroyed appropriately.
One person told us "I am happy living here".
One relative told us "The care is very good, my relative is as happy as they have ever been". Another told us "The atmosphere is relaxed, and they have supported my relative to set up his greenhouse which is important to him".
We found on our visit that a recent permanent recruitment of a registered manager has settled the service down well, and improvements were clear as a result of this.
'If I am unhappy my body language tells staff, they are aware of my likes and dislikes and activity plans are in place to ensure I do the things I do. Staff understand my communication methods.'
A visitor to the home wrote: 'Well done for supporting (the person) on the choice of presents for Christmas and birthday, they were all amazing.'
People were observed in the home environment interacting with staff according to their communication methods and appeared well cared for. People were dressed in a way which reflected their gender and personality. Some spent the day on several short trips; others remained at the home engaged in individual pursuits. The atmosphere within the home was relaxed and friendly and the people living at the home were attended to by staff according to the written plans of care. This ensured each person had the right care for their needs. Relatives indicated in written surveys that they were happy with the care. One relative wrote: 'Always receives excellent care and attention.'
A midday meal was observed. Some people used adapted cutlery and crockery to enable them to enjoy their meal independently. Staff were assisting people in an unhurried and friendly way and the atmosphere was calm and relaxed. People appeared to enjoy their meal.
People were observed enjoying the home environment and moving around it with ease.