Archived: Dean House

Updated 19 February 2016

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 Saturday 16 January 2016 and was unannounced. One social care inspector undertook the inspection.

Before the inspection we reviewed information we held about the service. This included previous contact about the home and notifications we had received. A notification is information about important events which the service is required to send us by law. We also contacted the local authority quality team to gain their views of the quality of the service provided.

On the inspection we spoke with eight people who lived at the home, the registered manager, the manager of the service, four visitors and three members of staff. We looked around the premises, spent time with people in the communal areas and observed how staff interacted with people throughout the day. We also looked at four sets of records related to people’s individual care needs; three staff recruitment files; staff training, supervision and appraisal records and those related to the management of the home, including quality audits. We also looked at the way in which medicines were recorded, stored and administered to people.

Updated 19 February 2016

Dean House is a long established care home in Torquay that provides personal care for up to 13 people with learning disabilities. There were 13 people living there at the time of our inspection. Some people had lived at the home for over 15 years, and were now developing long term physical health conditions associated with ageing or their learning disability.

One of the registered providers held the position of the home’s 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 registered manager was in the process of retiring and an application was being made by another person to become the registered manager. They were already the person in day to day control of the home and are referred to in this report as the manager as that was the role they were fulfilling. The registered manager visited the home three days every week.

This inspection took place on 16 January 2016 and was unannounced. The previous inspection of the home had taken place on the 14 November 2013, when the home had been found to be meeting all the standards inspected.

Risks to people had not always been clearly assessed and actions to mitigate risks had not always been recorded in a clear action plan. We found that some hot surfaces had not been fully protected and the hot water regulator to a bath and hand wash basin had failed. This meant the temperature of the water being delivered to this area could present risks to people. However we did not identify any people had suffered poor care as a result.

People told us they felt safe at Dean House. They told us it was like living with a family, and we saw people were settled, relaxed and comfortable living there. Relatives told us they had confidence in the home’s management and that their relation was safe and happy at the home.

Staff understood their responsibilities with regard to safeguarding people, and people were supported by sufficient numbers of staff. The staff team had not changed for several years which helped ensure people received consistent care from people who knew them well. Some historic staff recruitment practices had not been thorough, but the manager was taking action to address this retrospectively.

People told us they liked the food and had a good choice available to them. People told us they had been involved in choosing the meals and several had chosen to lose weight. They were working with the staff to provide healthy versions of their favourite meals. We saw people being actively involved in making choices about foods they wanted to eat.

Medicines were stored and administered safely. Staff had received training in the medicines they were giving to people and the systems were regularly audited to make sure that safe practice was maintained.

Staff had received training in and understood the Mental Capacity Act 2005. People’s capacity to make decisions was kept under review. The manager was aware of actions that would need to be taken where people had reduced capacity. Staff understood people’s communication where this was not verbal. Advocacy services would be identified for people if they needed additional support in making decisions.

Each person had a care plan which detailed their choices and preferences in relation to their care. Plans were written with people or their relations and were available in formats people could understand. They reflected people’s wishes, skills and aspirations as well as areas in which they needed support. The manager was enthusiastic about helping people develop new skills and have new experiences. People followed an active programme of individual activities. One person told us they were “very busy all the time”.

Staff confirmed there were clear lines of authority within the management structure and they knew who they needed to go to, to get the help and support they required. Staff said they had a very good relationship with the manager who was always available if needed. They told us the manager was “really wonderful”.

Policies were in place for dealing with any concerns or complaints and this was made available to people and their families in appropriate formats. People said they would be happy to speak with the registered manager or staff if they had any concerns.

The manager undertook audits of practice at the home and there were other quality assurance systems in place such as residents meetings and questionnaires. The results of feedback were included on the home’s development plan and people received feedback on the actions taken. Records were well maintained.

The building was subject to an ongoing programme of refurbishment, but all areas seen were clean and comfortable. People told us they were involved in keeping their own rooms clean, and were proud of them.