Archived: Dunraven House and Lodge

This visit to the service took place on 29 February 2016. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a supported living service. We wanted to make sure the provider would be available to support our inspection, or someone who could act on their behalf. The provider was available throughout the visit.

The provider was an individual who was in day to day charge of the service. The service does not have a condition of registration that they need to have a registered manager in place, because the provider was undertaking that role.

The systems to ensure restrictions placed on people by the provider were lawful and authorised by the Court of Protection had not been followed. Some people had restrictions on access to their medicines and on informing staff of their movements. These restrictions had been placed on people because the provider assessed they were necessary to keep them safe. However, the provider had not taken action to ensure these restrictions were authorised by the Court of Protection before imposing them on people.

People who use the service were positive about the support they received and praised the quality of the staff. Comments from people included, “I like the staff and feel comfortable with them” and “I feel safe. They do a very good job”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them. People said there were enough staff to provide the support they needed and staff arrived when they said they would.

Staff understood the needs of the people they were providing care for. Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service and demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.

The service was responsive to people’s needs and wishes. People had opportunities to provide feedback about their care and there was a complaints procedure. People said they were confident any concerns or complaints they raised would be responded to and action would be taken to address their issue.

The provider regularly assessed and monitored the quality of the service provided. Feedback from people was used to make improvements to the service.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

As part of this inspection, we included other outcomes as part of our routine scheduled review.

During this inspection, we spoke with two people who used the service, two members of staff, and the provider. We spoke with one relative who was visiting on the day of our inspection. They explained they had plenty of opportunities to express their views regarding the care or treatment their relative received, and they felt listened to.

One person told us 'there is consistency in the staff which is very important to me. They recognise if I am not feeling well and take action such as calling my doctor. The staff ensure I have plenty of opportunities to express my views regarding the care or treatment I receive.'

People's needs had been assessed, and we observed care and treatment being delivered in line with the individual's care plan.

People told us they always had staff support when they needed it.

Each person told us they knew how to complain and would approach any of the staff or the provider with their concerns, and were confident they would be listened to and taken seriously.

People knew the provider and manager because they had lived in other registered services owned by the provider. They knew their responsibilities and the rules for example, not smoking inside the property.

One person was able to tell us what the agency staff did for them and what time they visited. People did not have copies of their care records in their own home. They did not know which staff would visit and a rota of the personal care which would be delivered on each visit was not provided.

The people we asked explained how the decision to move into a more independent living environment was reached. We were told these decisions had been made together with them, their families and care managers. One person's comments showed they made decisions about their care and treatment. While the comments made by another person showed they were supported by their care manager. This means people were supported by the staff to make decisions but only if they did not conflict with conditions imposed under section of the Mental Health Act 1983.