Archived: Danesfield Supported Living Service

Updated 16 March 2017

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.

This inspection took place on 23 and 31 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We needed to be sure someone would be in when we visited.

The inspection was carried out by one adult social care inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed the information we held about the home. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. We also contacted the local authority commissioners of the service, the clinical commissioning group (CCG) and the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider completed a provider information return (PIR) prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with seven people living at the service. We also spoke with the registered manager and two care workers. We looked at a range of records which included the care records for four people, medicines records for 15 people and recruitment records for two care workers. We also looked at a range of other records related to the running of the service.

Updated 16 March 2017

This inspection took place on 23 and 31 January 2017 and was announced. The service was last inspected on 16, 23 and 25 November 2015 and was found to be meeting the legal requirements we inspected against.

Danesfield Supported Living Service provides care and support for 15 people in their own homes including 24 hour care. This includes care and support for people with a learning disability, mental health problems and physical disabilities.

The service had a 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.

Medicines care plans were not always accurate. For example, one person’s medicines care plan described a level of support the person had never received previously. Another person’s care plan contained conflicting information about the support they needed with medicines. Reviews carried out of these care plans had not identified the discrepancies. Both of these care plans had been re-written before our inspection had concluded.

Other records related to the receipt, administration and disposal of medicines were accurate and complete.

Incidents were logged and action was taken to help keep people safe. All of the incidents related to medicines errors. The number of errors had reduced due to the action the provider had taken.

Care workers had a good understanding of safeguarding and the provider’s whistle blowing procedure. They told us they did not have concerns about people’s safety but would not hesitate to raise concerns if required. Previous safeguarding concerns had been dealt with in line with the provider’s safeguarding procedure.

People were happy with their care and the care workers supporting them. They also felt the service was safe.

The quality of information and level of detail recorded in risk assessments had improved since we last inspected. Risk assessments had been completed across a range of areas such as medicines, finances and specific medical conditions.

People and care workers confirmed there were sufficient care workers on duty to meet people’s needs in a timely manner. Care workers also told us staffing levels had improved recently.

Effective recruitment procedures were in place to help ensure new care workers were suitable to work at the service. This included requesting two references and a Disclosure and Barring Service (DBS) check.

The provider had up to date procedures to deal with emergency situations and to ensure people continued to receive the care they needed.

Care workers were well supported and had access to training relevant to their caring role. Records we viewed confirmed supervisions, annual appraisals and essential training were up to date. Essential training included safeguarding adults, food hygiene, moving and handling and first aid.

The provider followed the requirements of the Mental Capacity Act 2005 (MCA). Care workers supported people to make as many decisions and choices as possible. Care workers told us most people understood verbal communication and were able to make daily living choices.

People were supported to prepare meals and drinks in line with their individual needs. Support provided included help with preparing meals and advice about healthy eating. Nome of the people using the service required any practical assistance with eating and drinking or special diets.

People were supported to access health care when needed, such as support to make and attend appointments.

People's needs had been assessed and information gathered about their individual care needs and preferences. Personalised care plans had been written which people had checked to confirm they were happy with what was in their plan.

Activities were available for people to participate in both within Danesfield and in the local community. These included going to the shops, college, local day clubs, out for walks, swimming, visiting relatives, going to the pub, the pool club and the gym.

People did not have any concerns about their care but knew how to raise concerns if they were unhappy. There had been no complaints received since we last inspected the service.

People had opportunities to share their views about the service through attending regular meetings and questionnaires. Initial feedback from the most recent consultation was positive.

Care workers told us they were able to share their views and suggestions about the service, either speaking directly with the registered manager or during regular supervisions and staff meetings.

The current systems of quality assurance had not been effective in identifying that medicines care plans for some people were inaccurate.

The provider’s commissioning team carried out periodic reviews of the quality of the service. The provider had made progress towards completing a comprehensive improvement plan for the service.