Archived: Draycombe House

Draycombe House provides care for a maximum of six adults with a learning disability. It is a large detached property, which is relatively close to shops and local amenities. Accommodation is situated on the ground floor with some en suite facilities available. Private car parking is available in the grounds. There were five residents living at the home at the time of the inspection.

The service also provides a small domiciliary personal care service to three people in the local area. This includes one person who lives independently on the premises of Draycombe House.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the provider and manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

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

People were protected from the risk of abuse and avoidable harm by staff who were trained to protect them and experienced to respond to concerns. The management team ensured any incidents were recorded and investigated. People were supported to manage the risks in their daily lives. Staff continued to be recruited safely and sufficient numbers of staff supported people to maintain an independent life as possible. Medicines were managed safely. Infection control systems and audits continued to ensure a clean environment and reduce any risks.

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. People’s needs were assessed prior to them living at Draycombe House. People were encouraged to support staff with food shopping and cooking meals as part of their care plan if they wished to. Healthy eating was promoted and people enjoyed meal provision at Draycombe house. Staff confirmed they had received training and access to courses was supported by the management team. The service continued to work effectively with healthcare professionals. Visits and outcomes were recorded to ensure people received the right care.

People told us staff were caring and always showed kindness, respect and compassion. People, and where appropriate their relatives had been consulted about their care needs They were involved in the care planning process. Staff worked in respectful ways to maintain people's privacy and dignity.

People received person-centred care which was responsive to their needs. Care and support plans had been regularly reviewed to reflect any changes in the person’s care. Activities in the home and the community were arranged in consultation of peoples wishes and interests. People were encouraged to raise any concerns. No formal complaints had been received since the previous inspection.

The provider used a variety of methods to assess and monitor the quality of the service. These included regular audits, meetings and surveys to seek their views about the service provided.

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

Rating at the last inspection

The last rating for this service was good (published 12 January 2016)

Why we inspected

This was a planned inspection based on the previous rating

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

Draycombe House provides care for a maximum of six adults with a learning disability. It is a large detached property, which is relatively close to shops and local amenities. Accommodation is situated on the ground floor with some en suite facilities available. Private car parking is available in the grounds. There were five people living at the home at the time of the inspection. The service also provides a small personal care service to three people in the local area. This includes one person who lives independently on the premises of Draycombe House.

There was a registered manager in place who also owns 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.

At the last inspection in August 2015 we found the service was rated requires improvement and made three recommendations. These were in relation to risk assessments to people’s health and safety and governance of the home. The provider sent us an action plan saying they would meet the recommendations by November 2015. During our inspection visit on 12 December 2016 we found these actions had been completed.

We looked at two care records of people who lived at the home. Risk management had now been improved and well documented .They contained an assessment of people’s needs, including reviews of any risks associated with receiving care. These related to potential risks of harm or injury and appropriate actions to manage risk. Risk assessments were developed for when people were out in the community in order to keep people as safe as possible.

We found the provider had made improvements in the processes they had to monitor people’s safety and welfare. Audits had been developed to monitor and assess the quality of the service provided. This was so they could continue to develop and monitor their performance. The manager showed us new documentation intended to monitor and improve oversight of the service’s quality assurance.

During this inspection people were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes both at Draycombe House and when out in the community.

We observed people’s medicines were dispensed in a safe manner and they received their medicines on time. Staff had received related training to ensure medicines were administered correctly by knowledgeable staff.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People were supported to eat their meals where they chose and were offered a variety of meal options. Comments from people who lived at the home included, “We help make the meals so they are always nice”. Also, “Plenty and yes I love the food here.”

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. The registered manager discussed the applications which had been authorised and the restrictions in place to make sure people were safe. We saw staff were working within the law to support people who may lack capacity to make their own decisions.

People who lived at the home and who were supported in the community said staff had a kind and caring approach to care. One person we visited in their own accommodation said, “They come when I need them and they are so kind and caring.”

Staff said the manager was approachable and supportive in their roles. They held regular meetings to obtain staff comments, suggestions and concerns about the ongoing improvement of the home. One staff member said, “[Registered manager and manager] were always approachable. [Manager] is hands on and good to work for, very supportive.”

Draycombe house also provided a small domiciliary service to people in the community. We spoke with two staff who provided care and two clients who received practical support from the domiciliary service. All comments were positive and included, 'The staff are fantastic could not do without them.' Also, 'They help me with all my shopping and paying bills. All the staff know what they are doing and are excellent.'

People living at the home said they felt safe and well looked after and they liked living at Draycombe House. One person showed us their room and said, 'It's lovely and I have all my own furnishings.'

Staff told us that training was in place and they were encouraged to attend national care courses. Most of the staff team had completed national care qualifications. One staff member said, 'We are always updating training it's not an issue here.'

We contacted the Lancashire contracts monitoring team. They told us they recently visited the home in May 2013 and currently had no concerns with the service being provided.