Archived: Dorset Learning Disability Service - 20 Edward Road

Updated 31 October 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Dorset Learning Disability Services – 20 Edward Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 16 hours’ notice of the inspection. This was because the service is small and people are often out: we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service including the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also contacted the local authority quality improvement team to gather further information about the service. We used this information to plan our inspection.

During the inspection-

During the inspection we met the three people who lived in the home. The people living in the home did not use words as their main means of communication. We were able to observe staff interactions with people in the communal areas. We spoke with two relatives. We also spoke with four members of staff, the registered manager and a healthcare professional.

We looked at a selection of records which included;

Two care and support plans

Records of staff meetings

Medication Administration Records (MARs.)

Health and safety records

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism.

Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the operations director at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The provider was introducing Positive Behaviour support, restrictive practices were used in the home.

After the inspection

The provider sent information to help to validate the information seen during our site visit. This included information about staff training. We also spoke with a provider representative about development work.

Updated 31 October 2019

About the service

Dorset Learning Disability Service – 20 Edward Road is a residential care home which is able to provide personal care and accommodation to up to three people. The home specialises in the care of people who have a learning disability. At the time of the inspection three people lived together in the home.

People’s experience of using this service and what we found

The home had been developed and designed in line with the principles and values that underpin Registering the Right Support. Work was underway to enhance the principles and values behind this and other best practice guidance. This meant that staff were working to ensure that people who use the service could live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Whilst this work was being undertaken by the provider organisation, people's care was not always delivered in line with the Mental Capacity Act and restrictive practices were not being monitored effectively. There was a breach of regulation.

People were supported by staff who cared about them and worked together to meet people’s individual needs. Staff felt well supported and happy in their roles. This helped to create a relaxed and happy atmosphere for people to live in.

People were supported by staff who knew them well and were able to communicate with them This enabled people to make choices about their day to day routines. Work to enhance communication skills and systems within the home was ongoing.

People were supported by adequate numbers of trained and experienced staff to keep them safe and meet their needs. The provider had a robust recruitment process which helped to minimise the risks of abuse to people. People were very comfortable and relaxed with the staff who supported them. The specialised training needs of the staff team were being addressed. We have made a recommendation about the monitoring of how this training is implemented and embedded.

People’s needs were assessed, recorded, reviewed and met. Each person had a support plan which gave staff guidance about how people preferred to be cared for. Staff knew people well and were able to provide personalised support to people.

The provider worked with other health and social care professionals to make sure people received the care and treatment they required. This included meeting changing health care needs.

People benefitted from a provider and management team who has systems in place to monitor quality and implement improvements to the service people received. Recording was not always adequate to ensure monitoring was effective. We received assurances from the registered manager and senior staff that this would be addressed.

You can see what action we have asked the provider to take at the end of this full report.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection. The last rating for this service was good (published January 2017). There were no breaches of regulations.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.