SeeAbility - Denecroft Residential Home is a residential home that provides support to up to six people with learning disabilities and who may also have a visual impairment. The home is located in the centre of Guildford. On the day of the inspection there were six people living at the home. The people who live at the home have a range of complex needs and are supported with a full range of daily tasks, including personal care, support with nutrition and activities. The provider had recently recruited a new manager for the service who had an application in progress become the registered manager. 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. The new manager was present during the inspection.
The inspection was unannounced and took place on 5 July 2016.
The service was not consistently safe as we found that the temperature in the conservatory was excessive and uncomfortable for people. Whilst medicines were stored, administered and managed safely we found that improvements needed to be made in relation to ‘as required’ (PRN) medicines and protocols. Medicines audits were not always completed. We have recommended that the home follows the Royal Pharmaceutical guidance regarding this.
People were protected from harm because staff had the training and the ability to understand risk, reported accident and incidents in a timely manner and understood how to report suspected abuse so that action could be taken if necessary. There was a system in place to investigate incidents and accidents to prevent them from re-occurring. Action was also taken to learn from these to help provide better care to people.
Risk assessments had been completed to ensure the home was safe for people to live in and there were emergency arrangements in place should there be an emergency.
People were supported by sufficient number of staff who were recruited safely and had the skills and knowledge to support people.
Whilst the principles of the Mental Capacity Act (MCA) 2005 were being followed on a day to day basis there were some mental capacity assessments that were not in place. We spoke to the deputy manager who said these would be worked on immediately. Despite this staff supported people in their best interests and staff had a good understanding of the MCA. They offered people choices and respected their decisions.
People’s nutritional needs were met and people had a varied diet. Mealtimes were a relaxed affair with people being given adapted cutlery and crockery to help maintain their independence. Where needed staff used pictorial aids to help people choose the food they ate.
Staff ensured people were supported to maintain their health and wellbeing and there were good links with other healthcare professionals.
People were cared for by staff who put people at the centre of all they did. Relatives informed us that they always felt welcome when visiting and that staff were available to speak to whenever they needed to. People were not rushed by staff and were treated with dignity and respect. People were encouraged to maintain relationships with their family and those that mattered to them.
People’s care was person centred and care plans and reviews reflected this. Staff were responsive to the needs and wishes of people. The environment was adapted to support people with a visual impairment and some equipment that had been introduced helped people maintain independence. The manager reviewed support needs regularly and learnt from experiences. People had a say on how the home was run and people and relatives felt comfortable in raising a concern or making a complaint. They told us they felt confident any complaints would be responded to appropriately.
The home was led by a manager who was positive and transparent way. Organisational values were reflected in the support given by staff, volunteers and the manager. The volunteer coordinator helped raise the profile of the service and helped support people to be part of the local community by creating links with local organisations.