Dyneley House

Dyneley House is a residential home providing accommodation and personal care for up to 24 people. Care is provided across 3 separate floors. Some people using the service are living with dementia. At the time of our inspection, there were 20 people living at the home.

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

People and relatives were overwhelmingly positive about the quality of care provided at the home. One person commented, “I think it is well managed because it couldn’t be a better place” and a relative told us, “It is brilliant here.”

Most aspects of medicines were safety managed but there were areas for improvement in the recording of topical medicines and thickening agent used for people with swallowing difficulties. Action was immediately taken when these aspects were raised. We received mixed feedback about staffing levels, but we did not find evidence of staffing levels having a negative impact on people's needs not being met. Risks to people’s care were identified, monitored and actions put in place. There were infection and prevention control processes and procedures in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager was passionate about providing high quality care to people and support to staff. People were engaged in activities they enjoyed, and everyone told us they would recommend the service to others. Care plans were detailed and centred around people's needs. There were quality assurance processes in place to ensure areas for improvement were identified and acted upon, and these had been mostly effective.

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 25 July 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The inspection took place on 25 May 2017 and was unannounced.

There was a registered manager at the service. 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.

People were safe. Staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough, appropriately recruited staff to safely provide care and support to people. Medicines were well managed and people received their medicines as prescribed. Emergency systems had been put in place to keep people, visitors and staff safe.

The service was effective. Staff received regular supervision and training needed to meet people's needs. Arrangements were made for people to see their GP and other healthcare professionals when required. People's healthcare needs were met and staff worked with health and social care professionals to access relevant services. The service was compliant with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People's views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that was easy to understand. People were supported to maintain relationships with family and friends. People were supported to eat and drink enough.

People received a high standard of personalised care that was responsive to their needs. It was clear during our inspection that the registered manager had worked with the staff, people and relatives to look for ways that would improve people's lives. The registered manager had introduced a number of initiatives to the staff team and it was clear that the service had continued to develop since our last inspection visit. People received person centred care and support. They were offered a range of individual activities both at the service and in the local community, based upon their hobbies and interests. People, relatives and staff were encouraged to make their views known and the service responded by making changes. Transitions for people moving to the service were well planned. Staff worked to ensure people had access to healthcare services.

People benefitted from a service that was well led. The registered manager and senior staff were well respected and demonstrated good leadership and management. They had an open, honest and transparent management style.

The provider had systems in place to check on the quality of service people received and any shortfalls identified were acted upon. The vision and values of the service were effectively communicated. The management team had a clear plan for further developing and improving the service people received.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. Relatives we spoke with told us they felt confident people were safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support.

People's health and care needs were assessed with them or their relatives. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People who used the service said that they had been involved in writing them and they reflected their current needs.

People's needs were taken into account with the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.

Visitors confirmed they were able to see people in private and that visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. People commented, 'All staff are very kind, helpful and loving. Everybody gets on together,' and 'I just cannot praise them (staff) highly enough.'

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People regularly completed a range of activities.

Relatives of people who used the service knew how to make a complaint if they were unhappy. Although relatives we spoke with told us they had not needed to make a complaint, they told us they were confident any issues would be addressed immediately. People could therefore be assured complaints would be investigated and action taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

On the day of our visit the provider had organised an 'Oriental' lunch. We saw people who used the service and relatives eating the meal together. The atmosphere was relaxed, people were engaged in conversations and the staff interacted with people appropriately.

We spoke with three people who used the service and five relatives. They were all highly complimentary about the service. People who used the service told us that they 'Could not be in a better place.' and they 'Like it very much here'. One of the relatives we spoke with said the home was 'Absolutely wonderful' and another said the home was 'Excellent'.

People who used the service had individual care plans and 'Life Stories' that described the things that were important to them and what they liked to do. Their care plans were reviewed and updated each month and reflected their needs and preferences.

The provider had an effective system to identify, assess and manage risks to the health, safety and welfare of people using the service and others. The views of people who used the service, their relatives and regular visitors the home were sought and the responses shared.