The Duke's House

Updated 11 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector.

Service and service type

The Duke’s House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Duke's House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We spoke with colleagues from the local authority, and we used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with six people who used the service and nine relatives of people living at the home about their experience of the care provided. We spoke with ten members of staff including the registered manager. We also spoke with one of the area managers from the provider.

We reviewed a range of records. This included four people's care records and multiple medication records. We looked at two staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, including training, quality assurance and policies and procedures were reviewed.

Updated 11 August 2023

The Duke’s House is a residential care home providing accommodation and personal care for up to eight people. The service provides accommodation, care and support to autistic people and people who have a learning disability. At the time of our inspection there were six people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

The design of the service and the use of space both inside and outside the home matched people needs and preferences as much as possible. People were now involved in decisions regarding the design of the service.

Staff were skilled in supporting people to express their views and make decisions. People were listened to and they were involved in decision making in many different aspects of their care and support. There was a lot of emphasis on doing everything possible to enable good and effective communication with people living at the home and others.

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.

Right Care:

People were supported and treated well. Staff showed and the service was designed in a way that respected people as individuals.

Staff were positive about the people living at the home. It was clearly important to staff that people did well and it was obvious that staff gained satisfaction from supporting people and they expressed joy when describing to us how people were doing well. This approach from staff had a positive impact on people. We asked one person how they were doing at the home and they told us, “I’m amazing.”

Each person’s care and support was planned with the person and those important to them. People were helped to think about what was important to them, their likes and dislikes, how they wanted to be supported and what they wanted their future to be like.

People family members spoke positively about the care planning process. One person’s relative told us, “I’m involved in care planning, they ask me what I would like for [Name] in the next couple of years and we set goals together. It’s good that they are trying different things… they are very, very responsive. All the staff are brilliant, [registered manager] has built a positive culture and now [Name] looks great, they are happy and doing so well.”

Right Culture:

There was a positive and empowering culture at the home, that had promoted people having positive outcomes. Staff had positive, natural and everyday interactions with people that were kind, enabling and very respectful.

People were leading full, busy and active lives, within their communities. They had been supported to expand their interests and hobbies, have new experiences, and enjoy relationships with people that were important to them.

The registered manager and other staff members were very responsive to any complaints or concerns raised with them.

Family members told us the registered manager had built up trust with them. One relative told us, “I have confidence in them now, they have gained my trust. They went out of their way to win my trust.” Another family member said about the registered manager, “[Name] always keeps her word.” A third family member described there being a generous spirit at the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 July 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

This service has been in Special Measures since 3 April 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We carried out an unannounced inspection of this service on 22 April 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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