We carried out an unannounced inspection on 7 February 2012 to follow up on compliance and improvement actions set following an earlier inspection in August 2011.On the day of our visit there were five people living at Davie House.
When we visited in August 2011 we found that people were satisfied with the care and support provided at Davie House and the attitudes of staff. However, there was a lack of detailed care/support plans and risk assessments combined with incomplete, disorganised, out of date information and many records were not signed or dated by the staff member who had completed them. The provider wrote to us with a plan for improving people's care files which would be done with input from people living at the service, their support team, family and other professionals and senior managers.
At our visit in February 2012 we were able to see that improvements had been made to care files and were being continually developed.
In August 2011 we had received information from the local authority which indicated that there may not be enough staff on duty in order to meet the specific needs of people. This was discussed during our inspection in August 2011 and at that point there was no evidence to say people's needs were not met due to lack of staffing. We decided to re-visit this at our follow-up inspection. When we visited in February 2012, we spoke to the manager again about this and they acknowledged that they had staffing issues the latter part of last year due to staff sickness, but they had been able to alleviate the problems by drafting in staff from another service of Self Unlimited who knew Davie House and the people who lived there and had the necessary skills and training to meet people's needs. They stated that people's needs were continued to be met at this time.
When we visited in August 2011 we found that Davie House did not have effective or comprehensive quality monitoring processes in place. The provider wrote to us with a plan for improving this by introducing new systems of monitoring the quality of service provision locally. This would include an annual questionnaire that would be sent to people living at Davie House and the people acting on their behalf, with the feedback being collated and an action plan drawn up from the results, with the information being shared with all key stakeholders.
At our visit in February 2012 we were able to see that improvements had been made, with the implementation of an annual audit report entitled 'Essential Standards of Quality and Safety Audit Report'. We were able to see that this had been developed in line with the Health and Social Care Act regulations and Care Quality Commission outcomes. The audit had been completed on 18 January 2012 by a manager from another Self Unlimited service and highlighted the areas for improvement and when these needed to be completed by.
When we visited in August 2011 we found that there had not been a manager registered with the Care Quality Commission since 2010. Since our visit, a manager had started the application process for this position in October 2011 and were awaiting criminal record bureau clearance.