This inspection took place on 15 January 2015 and was unannounced. This meant the provider did not know we were carrying on the inspection on that day.
We carried out our last inspection in August 2013. The provider during that inspection met our regulatory requirements.
East Dene Court provides care for up to nine people with learning disabilities. Nursing care is not provided.
The home is a large detached house with ten bedrooms, three lounges, a kitchen and a dining room. It is set in its own gardens in a residential area, near to public transport routes and local shops.
The service had a registered manager in place. 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.
Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff were responsive to people’s needs and wishes and we viewed records that showed us staff were enabled to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended training and development activities to maintain their skills. We also viewed records that showed us there were safe and robust recruitment processes in place.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We discussed DoLS with the registered manager and looked at records. We found the provider was following legal requirements in the DoLS.
We saw people’s care plans were very person centred and written in a way to describe their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for service users to understand by using of lots of pictures and symbols. We saw lots of evidence to demonstrate that people were involved in all aspects of their care plans. People, who used the service, and family members, were extremely complimentary about the standard of care provided.
Throughout the day we saw staff interacting with people in a very caring and professional way. The registered manager and staff that we spoke with showed genuine concern for peoples’ wellbeing and it was evident that all staff knew people at the home very well. This included their personal preferences, likes and dislikes and had used this knowledge to form very strong therapeutic relationships. We saw all of these details were recorded in people’s care plans. We found that staff worked in a variety of ways to ensure people received care and support that suited their needs.
People were protected from the risk of abuse. The care staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They had undertaken training and were able to describe the different ways that people might experience abuse. Staff were able to describe what actions they would take if they witnessed or suspected abuse was taking place.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. A designated infection control champion was in post and we found that all relevant infection control procedures were followed by the staff at the home. We saw that audits of infection control practices were completed.
People received a balanced diet. We saw people could choose what they wanted to eat each day and this was supported by the staff. The cook was very knowledgeable about peoples’ diets and their preferences were always available. There was fresh fruit and snacks available so people could help themselves throughout the day.
We saw the provider had policies and procedures for dealing with medicines and these were followed by staff. Medicines were securely stored and there were checks and safeguards in place to make sure people received the correct treatment.
There was a complaints policy at the home which provided people who used the service and their representatives with clear information about how to raise any concerns and how they would be managed. We saw pictures had been used to help people understand the information. The staff we spoke with told us they knew how important it was to act upon people’s concerns and complaints and would report any issues raised to the registered manager or provider.
We found that the provider had very comprehensive systems in place for monitoring the quality of the service. This included monthly audits of all aspects of the service, such as infection control, medication, learning and development for staff which were used to critically review the home. We also saw the views of the people using the service, their advocates and relatives were regularly sought and used to make changes. We found that the manager produced action plans, which clearly showed when developments were planned or had taken place.