We carried out a review of the data available to us about Duncan House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Duncan House, you can give feedback on this 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.
This inspection was unannounced. Duncan House is one of eight separate care homes within the Purley Park Trust Estate. Duncan House provides personal care and support for up to eight people who have learning disabilities. There were eight people living at the service when we visited.
The manager assessed and monitored the quality of care consistently with the help of staff and other members of staff in the company. However, the systems were not always effective as we found some inaccurate records. People received their prescribed medicine safely and on time. However, records of medicine stock were not always accurate.
Staff received a thorough induction when they started work at the service. They understood their roles and responsibilities, as well as the values and philosophy of the service which we saw were put into daily practice. Staff were up to date with their training which helped them to perform their roles and responsibilities and care for people effectively. People felt happy and supported by staff.
The managers and staff were knowledgeable about Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). Staff were following the principles of the MCA when supporting people who lacked capacity to make a decision. They had taken appropriate action with the local authority to determine if anyone was being restricted of their rights and liberties. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The DoLS provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm.
People felt safe at Duncan House and were protected from abuse. Staff knew how to identify if people were at risk of abuse and knew what to do to ensure they were protected.
The registered manager ensured there were enough qualified and knowledgeable staff to meet people’s needs at all times. The provider had employed good staff. Staff were focused on following the best practice at the service making sure people received appropriate care and support. The service took steps to make sure the care was based on local and national guidance.
There were robust recruitment processes in place. All necessary safety checks were completed to ensure prospective staff members were suitable before they were appointed to post.
People were able to have a nutritious and balanced diet. Hot and cold drinks and snacks were available between meals. People had their healthcare needs identified and were able to access healthcare professionals such as their GP. Staff knew how to acquire specialist professional help when required.
People and relatives told us good things about the service they or their family member received. Our observations and the records we looked at confirmed the positive descriptions people and relatives had given us. Staff understood the needs of the people and we saw care was provided with kindness and compassion. People told us they were happy with their care.
Throughout our inspection we saw examples of appropriate support that helped make the service a place where people felt included and consulted. People and their families were involved in the planning of their care and were treated with dignity, privacy and respect.
We have made a recommendation about keeping up to date and accurate records.
People were involved in making decisions about the house they lived in and the support they received. We saw that staff knew people well and were working hard to get to know the newest member of the house. People were encouraged and enabled to participate in activities, both on and off site. Risks were assessed and actions taken to minimise them without having a negative impact on people's lives.
There were processes in place to ensure that medicines were ordered, stored and administered appropriately and safely.
Staff felt supported and there was a comprehensive training and supervision programme in place.
People, their visitors and representatives knew how to complain. Complaints were logged and responded to appropriately and in a timely manner.
People’s care was delivered in line with their individual support plan which they helped to write and review. We spoke with three staff members who were aware of the support each person required. There was a wide range of activities for people to participate in; these were constantly reviewed so people could try new things.
One person we spoke with told us that they liked living in Duncan House and felt happy and safe.
There were sufficient staff on duty and the provider reviewed the needs of the people living in the house regularly in order to ensure that there were enough staff at all times.
The provider had an effective way of assessing and monitoring the service they provided.