Dinorwic Road

Updated 7 November 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was conducted by an inspector.

Service and service type

The service is a 'care home'. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home had a manager registered with CQC. This means that they, and the provider, are legally responsible for how the home is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was conducted over one day. We gave the service 48 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did

We reviewed information we had received about the home since it was registered. We assessed the information we require providers to send us at least once annually to give some key information about the home, what it does well and improvements they plan to make. We used all this information to plan our inspection.

We spoke with two people living at the home and observed staff providing support at lunchtime. We spoke with the registered manager, an operations director, a senior support worker and a support worker.

We reviewed a range of records. This included two people's care records, two staff files and other records relating to the management of the home.

After the inspection

We spoke with two relatives of people living at the home. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 7 November 2019

About the service

Dinorwic Road provides specialist care for people with learning disabilities and/or autism. The home is registered to provide care for three people. At the time of our inspection there were two people living at the home. Dinorwic Road is a large domestic property in a residential area of Southport close to local amenities.

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 registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

People’s experience of using this service

People’s individual needs and preferences were consistently considered as part of the care planning process. Their needs and preferences were reflected in the way care was provided. Care and communication methods were sensitively adapted to promote people’s independence and choice. People were encouraged and supported to take the lead in assessment and care planning processes with the support of staff. People and their relatives were actively involved in setting and reviewing short and long-term goals. There was clear evidence this approach had improved people’s skills and independence and reduced anxiety.

Staff understood the need for effective communication and exceeded the requirements of the Accessible Information Standard. Important information was also made available in a range of accessible formats to help people understand and to promote their involvement in decision-making. Staff’s creative and flexible approach to communication meant people could always express themselves. There was evidence in care records this had resulted in lower levels of high-risk behaviours and improvements in people’s health and wellbeing. People were supported to enjoy a range of personalised activities in their own home and the wider community. Activities reflected people’s needs and preferences and were also beneficial in developing their independence.

Systems and processes for keeping people safe were highly developed and effective. Risk was assessed in good detail and supported by appropriate care plans. There was clear evidence of the service learning from incidents and feedback. Staff were deployed safely in accordance with people’s needs. Medicines were managed safely in accordance with best-practice guidance.

Staff were given a thorough induction and supported with regular additional training and supervision. People were supported to exercise choice and were involved in shopping for ingredients for their meals. The building had been decorated in a way which reflected the preferences of the people living there and was noticeably homely. There was evidence of regular contact with community health services and referrals were made in a timely manner. The service was working in accordance with the principles of the Mental Capacity Act 2005 (MCA). People were asked for consent and given choices in relation to their care and other important decisions.

People living at the home were treated with kindness and respect. There was a strong, natural person-centred culture which was evident in our observations and the actions and comments of all staff. People were encouraged to comment on the provision of care and were actively involved in the decision-making process through discussions with staff and regular reviews. People’s rights to privacy and dignity were maintained at all times.

The managers and the staff we spoke with demonstrated their commitment to providing high-quality, person-centred care. Staff understood their roles and responsibilities within the service. Safety and quality were effectively managed through the application of robust systems. The provider placed continuous learning and improvement at the heart of their practice. Lessons learnt from incidents and accidents were shared with staff to improve practice.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Rating at last inspection and update

The last rating for this service was Good (published 28 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dinorwic Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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