The Care Quality Commission
  • Care Home
  • Care home

Archived: Davie House

Overall: Requires improvement read more about inspection ratings

33 & 34 New Park, Horrabridge, Yelverton, Devon, PL20 7TF (01822) 854656

Provided and run by:
HF Trust Limited

Important: The provider of this service changed. See old profile

All Inspections

20 September 2016

During a routine inspection

This unannounced inspection took place on 20 September 2016. We returned on 21 and 22 September 2016 to complete the inspection. At our inspection in June 2015 Davie House was rated ‘requires improvement’ overall. There were four breaches of the Health and Social Care Act (2008) due to insufficient recruitment practices, discrepancies of medicine dosages, record-keeping in general was not robust and there were maintenance issues of the building. We received an action plan from the organisation detailing how they would be meeting the regulations which were in breach. This inspection found some improvements had been made. However, we found further breaches for medicines management, an inconsistency of staff to support people appropriately to meet their individual needs and issues with how the service was managed.

Davie House is registered with the Care Quality Commission (CQC) as 33 and 34 New Park which is located in the village of Horrabridge close to Dartmoor National Park. The two properties consist of number 33 and 34, which are adjacent semi-detached houses on a residential housing estate. It is registered to provide accommodation with personal care for up to eight people over the age of 18 who have a diagnosis of a learning disability. When we inspected Davie House in both June 2015 and September 2016, we were told that Davie House only consists of number 34 New Park. Number 33, which is owned by HF Trust Limited, provides supported living for people, but is not registered for the regulated activity, personal care. No one was receiving personal care in number 33 at the time of this inspection. We established that the organisation was in the process of amending their registration address to just being number 34. At the time of our inspection there were four people living at Davie House.

There was a registered manager in post. 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. However, the registered manager informed us that 23 September 2016 was to be their last working day for the organisation. Therefore after this date there would be a registered manager vacancy at Davie House. A regional manager informed us that they had two applicants for the position and were due to commence the interview process.

A high use of agency staff due to the inability to recruit permanent staff had impacted on people. Some people had found this had increased their anxiety due to unfamiliarity and an inconsistency of support and approaches. This had led them to have challenging behaviour at times.

Medicines management was not robust. A medicine cupboard did not conform to the Medicines Act 1968 and certain medicines requiring refrigeration were not kept securely. There had been gaps in medicine records but these had been picked up and dealt with by the registered manager. Where a person was prescribed insulin it was not on the medicine record.

Agency staff did not have access to computerised records. They had access to people’s care plans and risk assessments to help them support people appropriately, but did not have access to daily notes. This meant that if there was only agency staff on shift, they were reliant on receiving a thorough handover and paper versions of notes about key information. This posed a risk they would not be aware of certain information if it had not been handed over.

Methods used to assess the quality and safety of the service had not picked up the issues with medicines management and how the use of agency staff had at times impacted on people’s behaviours and anxieties.

Where relatives had completed surveys, actions had not been followed up by the service.

People felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes.

Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them. Staff relationships with people were caring and supportive.

There were effective staff recruitment and selection processes in place. Staff received training and regular support to keep their skills up to date in order to support people appropriately.

Permanent staff spoke positively about communication and how the registered manager worked well with them.

We found three breaches 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.

11 and 19 June 2015

During a routine inspection

The inspection took place on 12 and 19 June 2015 and was unannounced. The service had been taken over and registered by HF Trust Limited in August 2013 and had not been inspected since then.

Davie House is registered with the Care Quality Commission (CQC) as 33 and 34 New Park which is located in the village of Horrabridge close to the Dartmoor National Park. The two properties are adjacent semi-detached houses on a residential housing estate. The service is registered to provide accommodation with personal care for up to eight people over the age of 18 who have a diagnosis of a learning disability. When we inspected Davie House in June 2015, we were told that Davie House only consists of number 34 New Park. We contacted the CQC registration team after the inspection and were told that the provider is submitting a new registration application, so that Davie House will be registered as number 33 New Park only rather than both houses.

At the time of inspection, the registered manager of Davie House had left in April 2015 and was in the process of voluntarily de-registering. A new manager had been appointed and had submitted an application to the CQC to register as the manager.

A registered manager is a person who has registered with the CQC to manage the service. Like registered providers and nominated individuals, 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 service provided to people living at Davie House was delivered by sufficient knowledgeable staff, who had been trained to support people with learning disabilities. Many of the staff had supported the people living there for many years and showed an in-depth knowledge of people’s history, needs and aspirations. Staff were supported to undertake training to support them in their role, including nationally recognised qualifications. Staff received regular supervision and appraisal.

Staff recruitment processes were not always safe as checks on people were not always fully completed.

People’s paper based records were not always complete and accurate, although there was a computerised system which did hold up to date information.

Medicines were administered and stored safely and there were audit processes which ensured that there were accurate records of stocks of medicines.

Although there were audits undertaken to ensure the safety and quality of the care provided, some audits did not identify some issues or actions to address them. These included checks which had been undertaken of new staff files and checks on the information held in care records. However senior staff said they would review these checks and ensure that these areas were improved.

People appeared happy and relaxed and staff interacted with them in a calm, relaxed and kind manner. People were offered a choice of activities in the community and chose what they wanted to do each day. These activities included going to a local town to attend an activities club, attending a local group, going on holidays of their choice and getting involved in domestic activities. One person volunteered at a local charity shop and another spent some time relaxing by cycling on their bike.

People’s needs and risks were assessed and care plans were developed to support them to be as independent as possible. Daily notes reflected the care described in the care plan. Where concerns about a person were identified, staff discussed how they could best address them. Changes were then written up in care plans and daily notes. Staff were aware of the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguard (DoLS) requirements and took them into account when working with people. The staff were in the process of setting up best interest meetings to ensure that DoLS applications were submitted for people where necessary. Staff were aware of how to protect vulnerable people from the risk of abuse and knew what to do if they had concerns.

People were supported to have their health needs met by health and social care professionals including their GP and dentist. People were supported to prepare and eat food, although there was not always a healthy option available at lunchtime.

We found breaches of the regulations 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 the report.