Duncan House

Updated 6 March 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was completed by one inspector.

Service and service type:

Duncan House is a care home (without nursing) which is registered to provide a service for up to eight people with learning disabilities. People in the home receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was 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.

Notice of inspection:

This inspection took place on 22 January 2019 and was unannounced.

What we did:

Before the inspection we reviewed the information we held about the service and the service provider. The registered provider completed a Provider Information Return (PIR). 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 looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.

We spoke to five people who use the service and observed interactions between them and staff. We looked at four care plans, daily notes and other documentation, such as medication records, relating to people who use the service. In addition, we looked at the records related to the running of the service. These included a sample of health and safety audits, quality assurance, staff and training records. We spoke with five staff members including, assistant managers, support worker, the registered manager and nominated individual. We spoke to two family members of people who live at the home. We requested information from ten external health and social care professionals and received two responses.

Updated 6 March 2019

About the service:

Duncan House is a is a care home (without nursing) which is registered to provide a service for up to eight people with learning disabilities. At the time of inspection Duncan House was providing support to 8 people. People had associated difficulties such as being on the autistic spectrum.

Duncan House accommodates people in a purpose built domestic sized building. The service was easily accessible to local amenities and with links to public transport. Each person using the service had their own bedrooms and access to communal areas. The service was run in line with the values that underpin the ''registering the right support'' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism can lead as ordinary a life as any citizen.

People’s experience of using this service:

The registered manager conducted quality assurance audits to monitor the running of the service. However, we found that these were not always effective as they didn't always identify gaps in medication records. People's medication records were not always accurate and had conflicting medicine information. People did not always have ‘as required’ medicine guidance in place. We recommend that the provider seeks guidance around the proper and safe management of medicines.

The registered person did not always inform of authorisations under the Deprivation of Liberty Safeguards as required in the Care Quality Commission Regulations. We recommended the provider ensures they understand their regulatory responsibilities to ensure they are complying with the regulations.

People remained safe at the service and risks around their well-being were assessed, recorded and regularly reviewed. People were supported by sufficient staff that knew them well. Recruitment procedures to appoint new staff were thorough. People were supported to take their medicines safely.

People received their care and support from a staff team, that had a full understanding of people's care needs and the skills and knowledge to meet them. Staff were given an induction when they started and had access to a range of training to provide them with the level of skills and knowledge to deliver care efficiently.

Staff treated people with respect and kindness at all times and were passionate about providing a quality service that was person centred. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

People's dignity and privacy was respected. People told us staff were reliable, friendly, and caring. Staff developed positive and caring relationships with the people they supported and used creative ways to enable people to remain independent.

The registered manager and the management team strived at creating an inclusive environment to strongly encourage staff, people and their relatives to be involved in the service.

Rating at last inspection:

At the last inspection which took place on the 17 and 18 May 2016 the service was rated Good in the domains of safe, effective, caring and responsive. The service was rated Requires Improvement in the domain of well led. Overall the service was rated Good.

Why we inspected:

This was a planned comprehensive inspection based on the rating at the last inspection.

Follow up:

We will follow up on issues that we identified by asking the provider to send us evidence of how and when the issues are sorted. We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next inspection is scheduled accordingly.