The inspection took place on 21 December 2016 and was unannounced. Dalmeny House provides accommodation, care and support for up to 11 adults with mental health needs, some of whom may also have a learning difficulty. At the time of our inspection there were nine people living in the home.
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.
There were enough staff working in the home to help ensure people's safety. Where there were unexpected staff shortages, staff worked well together, to ensure people's needs continued to be met safely and appropriately. Staff were recruited in a way that ensured proper checks were carried out, which helped ensure only staff who were suitable to work in care services were employed. Staff knew how to recognise different kinds of possible abuse and understood the importance of reporting any concerns or suspicions that people were at risk of harm appropriately. The registered manager also understood their role in addressing any issues.
Risks to people's safety were identified, recorded and reviewed on a regular basis. There was also written guidance for staff to know how to support people to manage these risks. Staff worked closely with healthcare professionals to promote people's welfare and safety. Staff also took prompt action to seek professional advice, and acted upon it, where there were concerns about people's mental or physical health and wellbeing.
People's medicines were stored and administered safely and as the prescriber intended and staff were trained and competent to support people in this area.
People enjoyed their meals and were provided with sufficient quantities of food and drink. People were also able to choose what they had. If people were identified as possibly being at risk of not eating or drinking enough, staff would follow guidance to help promote people's welfare and input would be sought from relevant healthcare professionals.
Staff were trained well and were competent in meeting people's needs. Staff understood people's backgrounds and preferences and supported people effectively. New staff were required to complete a probationary period and induction and all staff received supervisions and appraisals of their work.
Staff understood the importance of helping people to make their own choices regarding their care and support. Staff consistently obtained people’s consent before providing support and, if people lacked capacity to make some decisions, staff understood how to act in people’s best interests to protect their human rights.
Staff had developed respectful, trusting and caring relationships with the people they supported and consistently promoted people’s dignity and privacy. People were able to choose what they wanted to do and when. People were also supported to develop and maintain relationships with their friends and families. People engaged in a number of activities both in and outside of the home and were supported to maintain and enhance their independence as much as possible.
The service was well run and communication between the management team, staff, people living in the home and visitors was frequent and effective. People and their families and friends were able to voice their concerns or make a complaint if needed and were listened to with appropriate responses and action taken where possible.
There were a number of systems in place in order to ensure the quality of the service provided was regularly monitored. Regular audits were carried out in order to identify any areas that needed improvement, which were then acted upon.