Derham House

Updated 24 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 took place on 11 December 2018 and was unannounced. It was carried out by two inspectors.

Before our inspection we reviewed all the information we had about the service, including notifications sent to us informing us of events that occurred at the service. A notification is information about events that by law the registered persons should tell us about. We looked at the last inspection and spoke with the local authority commissioners.

We also received a Provider Information Return (PIR) from the service. A PIR is a form that asks the provider to give some key information about the service, what it does well and any improvements they plan to make.

During our inspection we spoke with four people who used the service, five relatives, ten members of care staff, one nurse, the activities coordinator, the maintenance person, the deputy manager and the registered manager. We reviewed five people’s personal care records, five staff records, staff duty rotas, medicine administration records and other records relating to the management of the service such as meeting minutes, health and safety records and staff training records.

We also carried out observations of people's interactions with staff and how they were supported. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection we spoke to four relatives on the telephone to seek their views about the service.

Updated 24 January 2019

This unannounced inspection took place on 11 December 2018. At the last inspection in August 2017, the service was rated as Requires Improvement. This was because we found that there were some shortfalls in maintaining accurate records of care delivered. Records were not always accurate and up to date. We asked the provider to complete an action plan to show what they would do and by when to improve the service. We did receive a comprehensive action plan within the time allocated to them. During this inspection the service demonstrated to us that improvements had been made.

Derham House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to provide accommodation for 64 people who require nursing or personal care. Bridge unit provides nursing care whist Foxhall unit also known as "Memory Lane" provides dementia care. On the day of our visit there were 57 people living at the service.

There was a registered manager in place. 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 told us they felt safe living at the service and staff understood their responsibilities to protect people from the risk of abuse. Risks associated with people's care were identified, and there was sufficient guidance for staff about how to keep people safe.

The registered manager and staff understood when and how to support people’s best interest if they lacked capacity to make certain decisions about their care. Staff had received training about the Mental Capacity Act 2005.

People were supported with their meals to ensure they received food and drinks they liked to help keep them as healthy as possible. They received their medicines as prescribed and medicines were managed safely. There were systems in place for the monitoring and prevention of infection.

There were assessments undertaken and care plans developed to identify people’s health and support needs. People were encouraged to make decisions about their care and support and the service ensured that information was provided to people in ways they could understand.

Staff received training in a variety of areas to ensure they had the skills to meet people's needs. They were supported through supervision and appraisals.

Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. Staff had developed good relationships with people who used the service.

The registered manager had regular contact with people using the service and their representatives. They welcomed suggestions on how they could develop the services and make improvements.

Regular audits were carried out to monitor the quality of the service and drive improvements.