Doughty's

Updated 25 January 2019

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

This inspection was a comprehensive inspection which took place on the 22 November 2018. The service was given 48 hours’ notice because the service provides people with care in their own homes and we needed to be sure that people would be willing and available to speak with us. We were also aware that the registered manager had retired in the preceding week, so we needed to be sure that there would be staff available to support the inspection team in providing the information and evidence required. This inspection was carried out by two inspectors.

Before the inspection we reviewed the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information that we held about the service. Providers are required to notify the Care Quality Commission about events and incidents that occur including injuries to people receiving care and safeguarding matters. We reviewed the notifications the provider had sent us. We gained feedback from Norfolk County Council quality assurance team and an external professional.

During our inspection we spoke with four people using the service. We also spoke with the nominated individual for the provider (the chief executive officer), the acting manager, the acting deputy and training manager, the administrator, one member of senior care staff and three care staff members. We observed how staff interacted with people receiving the service.

We looked at three people’s care records in detail including medicines records, two staff recruitment records and staff induction, training and supervision records. We looked at other documentation such as annual residents’ survey, quality monitoring documents as well as accident and incident records. We saw compliments and complaints records plus records from staff, residents and committee meetings.

Updated 25 January 2019

Doughty's is a historic charitable service which offers the registered activity Personal Care to older people living within its Alms House complex. The complex is a mixture of converted old Alms house flats and purpose built modern flats, which is situated within easy reach of central Norwich. The service is only available to people living on the site and as such is more comparable to a supported living scheme than a main stream domiciliary care agency. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of this inspection, of the 50 residents in the complex, 15 people were in receipt of personal care.

At our last inspection in May 2016 we rated the service good. At this inspection, on the 22 November 2018, we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. The service continues to meet all relevant fundamental standards. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

We received a high level of praise for the service. People using the service were very positive and complimentary about the service and told us they would recommend the service to family and friends whole-heartedly. Staff said they were proud of the service they provided and enjoyed working here, one commenting that their relative had lived in Doughty’s very happily for 20 years. An external professional also provided very positive feedback advising us that they use Doughty’s as an example of good practice.

The service had continued to build on its established good service, working both internally and in partnership with numerous outside agencies to provide the most appropriate and up-to-date methods of care and support. The service continued to seek improvements whenever possible. Improvements made since the last inspection included establishing electronic databases, establishing a separate training budget, developing a trainee carer pilot scheme with the local job centre, introducing external HR support and introducing a sophisticated electronic medicines administration system.

People who used the service all reported they felt safe and that staff were always available when they needed them. Staff all received training in adult safeguarding and knew how to recognise and act to help protect people against the risk of harm. Risk assessments were in place and staff were knowledgeable about the management of risks to people. A new electronic medicines administering system had been introduced which was effective and minimised the risk of errors. All the people we spoke to felt the care provided was effective in meeting their preferred outcomes and that staff were suitably skilled and very well trained. Several noted that they have had new carers come in but that the trainees are taught how to do things well and that the staff can always look at peoples’ care plans which detail what is required clearly. The service continued to show a strong commitment to staff development, both in terms of a comprehensive induction and an ongoing training programme; with the competency of staff checked regularly by management. The service worked closely in partnership with other professionals and voluntary agencies to improve the quality of life and encourage healthier, active lives for the people using the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

All the people we spoke to were complimentary about the staff attitudes and their approach to care-giving. We observed staff being respectful of people’s privacy and attentive to their wishes. Staff reported that they were actively encouraged by management to spend time talking to people, to enable them to know and respect people as individuals and support their preferences. People using this service told us staff responded quickly to their call bells and that care provision was timely and effective. People had their daily care plan checked and revised monthly by their keyworker alongside a weekly visit from one of the managers to check all is well. Doughty’s has maintained its accreditation for providing end of life care and endeavours to support a person’s preferred wish, if it is to remain at Doughty’s.

People using the service reported that management ran a ‘tight ship’. All the people we spoke to reported they had a good relationship with management and their opinion of the service was sought both informally and via annual surveys. Records showed the support plans were reviewed in detail by management twice yearly. Staff meetings were held regularly and staff reported feeling valued and well supported. Doughty’s have participated in various schemes to bring in additional expertise such as occupational therapy student placements and a cognitive stimulation therapy initiative which added value to people’s lives alongside upskilling staff. The service operates a development plan which shows they continue to seek ways to innovate and improve.

Further information is in the detailed findings below.