Dunblane House

About the service

Dunblane House is a large terraced house supporting up to four people living with learning difficulties. It is situated in a residential area of Blackpool close to local amenities. It is run as a domestic family household. People live with the owners and share the communal facilities. Each person has their own bedroom. There is an outside area with seating at the rear of the property. At the time of the inspection 2 people lived at the home.

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

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.

Right Support:

The service supported people to have choices and promoted their independence. This is a small family run home however staff had completed training to ensure they understood the meaning of the service they provided. People were supported to pursue their interests whilst living at Dunblane House. One person said, “I like going to the centre and enjoy playing dominoes.” People were encouraged to have maximum choice and control of their lives. The provider and staff helped them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s medication was managed by staff and required prompting support only. Staff were trained to administer medication.

Right Care:

People received kind and compassionate care from the provider and their family. One person said, “I am so glad to be a part of the family and live here.” The provider and staff protected and respected people’s privacy and dignity. They spoke about people with respect and were knowledgeable about people who lived at Dunblane House. Staff understood how to protect people from poor care and abuse. They had received training on how to recognise and report abuse. No new staff had been recruited since the previous inspection and the home was run as a family home. Where appropriate, the provider and staff encouraged and enabled people to take positive risks and live an independent life as possible.

Right Culture:

The service promoted person-centred care involving people who used the service and their families. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management team and staff. People were involved in planning their care. The provider and registered manager evaluated the quality of support provided to people. This involved the person, their families and other professionals as appropriate. Staff ensured risks of a closed culture were minimised, so people received support based on transparency and respect. The management team had an informal range of systems and processes to monitor the quality of the service and drive improvements.

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

Rating at last inspection

The service was rated good on the 08 July 2018

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support, right care and right culture.

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.

At our last inspection we rated the service Good in all domains. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The inspection visit took place on 05 June 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the service was a small care home for younger adults who are often out during the day, we needed to be sure someone would be in.

At the time of our inspection visit four people lived at Dunblane House.

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.

We spoke with people who told us they felt safe, comfortable and well supported by staff and observed interactions between staff and people. These were positive friendly and supportive.

Procedures were in place to minimise the risk of unsafe care or abuse and staff understood their responsibilities to report unsafe care or abusive practices. They had received training on safeguarding vulnerable people and knew how to do this.

Medicines were managed safely. People received their medicines when needed and appropriate records had been completed.

Care plans were focused on each person’s individual needs and preferences. Staff involved people and if appropriate, their relatives and records were informative about the care people received. Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people. There were sufficient staffing levels in place to provide the support people required and staff responded promptly when people needed assistance.

We saw people had access to healthcare professionals. People’s healthcare needs were met promptly. Staff provided care in a way that respected peoples’ dignity, privacy and independence. People told us staff cared for them in the way they wanted.

We looked around the home. The building was a large family home the registered provider and registered manager shared with the people they supported. We found it had been maintained, was clean and hygienic and a safe place for people to live.

The design of the building and facilities provided were appropriate for the care and support provided. We found equipment had been serviced and maintained as required. There were safe infection control procedures and practices and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of infection.

People told us they liked the meals and were involved in shopping for and preparation of food. Staff encouraged people to have sufficient healthy and nutritious food and drink.

People had been 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 indicated they enjoyed a variety of meaningful work opportunities, educational and leisure activities. These gave people the opportunity to develop new skills, socialise and get involved in a variety of activities.

People and where appropriate, their relatives were given information about how to complain. People we spoke with told us they felt able to complain and express any concerns. No-one we spoke with had any complaints. People also had information about support from an external advocate should this be required.

The registered provider and registered manager assessed and monitored the quality of the service. These included regular audits and ways to seek people’s views about the service provided. People told us the management team and staff were approachable and willing to listen.

Further information is in the detailed findings below.

Dunblane House is a large terraced house registered for four people with mental health problems. It is situated in a residential area of Blackpool. It is run as an ordinary domestic household. People live with the owners and share the communal facilities. The ground floor consists of a lounge and dining/kitchen area and one bedroom. There are four bedrooms, two have en-suite facilities. There are sufficient toilet and bathroom facilities available. There is a small garden area with seating at the rear of the property. At the front of the property there is parking for two vehicles. The house is close to all local amenities. At the time of the inspection three people lived at the home.

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.

At the last inspection in April 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Systems were in place to protect people from abuse and unsafe care. The three people told us they felt safe and were happy at Dunblane House. One person said, “Oh yes I have been here for years we are all a family. I feel safe with people around me.”

We looked at the care records for two people. There was information in place about support needs for each person and how these were being met.

We found the three persons who lived at the home had their healthcare needs met. For example they told us they had access to their doctors and dentists when they required treatment.

We found medication procedures in place at the home were safe. The three people had locked facilities and managed their own medication with supervision from the owners and staff. All had been trained to administer medication.

People who lived at the home were responsible for their food choices with help from the staff and owners. One person who lived at the home said, “We do choose the meals but change when we want to they don’t mind.” People helped themselves to drinks and snacks throughout the day.

The registered provider understood the requirements of the Mental Capacity Act 2005 MCA and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

People had freedom of movement around the building. They were involved in decision making about their personal care needs and the running of the home. We saw no restrictions on people’s liberty during our visit.

People were encouraged to follow their ambitions and individual interests within the community. They included voluntary work and attending education facilities.

People who lived at the home were encouraged and supported to maintain relationships with their friends and family members.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular auditing of the service and meetings with the people who lived at the home formally and informally.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Dunblane House is the home of the registered provider and registered manager. They live as a family with up to four people with mental health problems. There were three service users living at Dunblane House when we inspected. They had lived together at Dunblane House for many years.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. They told us they were receiving safe and appropriate care which was meeting their needs. They said the staff were good and kind.

The home had policies and procedures in relation to the Mental Capacity Act. People who lived at Dunblane House when we inspected, had the capacity to make decisions about their lives, given appropriate information. Staff were aware of the need to seek assistance if an individual's capacity changed. Staff were aware of Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. Service contracts were in place. Maintenance records we looked at showed that regular safety checks were carried out. Any repairs were completed quickly and safely. These measures ensured the home was maintained so people were safe. Systems were in place to make sure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People's health and care needs were assessed and reviewed with them, and they were involved in developing their plans of care. This included the way each person's care was provided, their daily routines, health needs and their hopes and aspirations. We saw that care plans were up to date and reflected people's current individual, dietary, cultural and religious needs.

People confirmed and records showed that they were able to see people in private and that friends and relatives could visit whenever they wished. People's needs were taken into account with the layout of the home enabling people to move around freely and safely.

Is the service caring?

People were supported by kind, attentive and informed staff. We saw that staff showed patience and gave encouragement and guidance when supporting people. Good care practices were observed. People told us that they were happy at Dunblane House and they liked living there.

Care plans were person centred had been maintained, recording the care and support people were receiving. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We found a range of meaningful work, educational, social and leisure activities were organised to encourage skills and enjoyment. People said they enjoyed these, particularly the regular visits to the owner's caravan in Wales. We observed people getting ready to participate in these and they were enthusiastic about them. Relatives said how much they benefitted their family members. One relative said, 'There is always so much going on. Staff also make sure that they support our son so he is always involved in all our family occasions and celebrations.'

People knew how to make a complaint if they were unhappy. They said they had no complaints but indicated that if they had they would be dealt with quickly. We discussed how minor niggles were dealt with quickly and to the satisfaction of people who lived at Dunblane House. There was a complaints procedure and any complaints would be dealt with in a timely manner and action taken as necessary.

Is the service well-led?

The service had a quality assurance system in place and planned to further develop this. Records showed that any identified problems were addressed promptly. Staff reflected on whether any incidents could have been managed more effectively or if lessons could be learnt. As a result of these measures the quality of the service was continuously improving

Staff had a good understanding of their roles and responsibilities and of the ethos of the home. As a small staff team of four, staff worked closely together and with service users. As well as regular informal chats meetings were held regularly so everyone could discuss support needs and any changes in care or routines. Staff also received regular supervision to assist with their development. This helped to ensure that people received a good quality service at all times.

"This is a lovely place to live. Good home cooked meals with plenty of variety and choice. We all get on very well".

"They are very kind people. They look after us so well".

"Fully involved in decision making about my care and the running of the home. I am encouraged to maintain my independence which I like".

"I couldn't wish for a better place to live. I am happy with everything".