Drakes Place

We gave the provider 24 hours’ notice because we wanted to make sure the provider was available on the day of the inspection. We also wanted to speak with people who used the service and wanted to be certain they were available to meet with us.

Drakes Place is a 26-bedded service for adults with a learning disabilities or physical disabilities. The home is split into three separate homes (units) with support from one staff team. All areas can be accessed from the main home, although each unit has its own front door and individual names that included, The Oaks and Squirrel Park. The main home had 14 beds, The Oaks had five beds and supported people with physical disabilities, and Squirrel Park had eight beds and supported people with more complex learning disabilities. The home had the benefit of a hydrotherapy pool. All people living at the home could access the pool with support from staff. At the time of the inspection there were 24 people living in the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that showed 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 people we met on the day of the inspection had complex physical and learning disabilities. Some of the people we met could verbally communicate with us and others could not. To capture the opinions of people who could not communicate directly with us, we saw people’s interactions with staff and their reactions. We also spoke to people’s relatives to help us form a judgement.

The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy.

There was a registered manager in post. 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.

Why the service is rated Good.

People told us they felt safe living at Drakes Place. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. There were enough numbers of staff available to keep people safe.

Staff supported people safely with their medicines if required. Staff had proper skills, knowledge and experience to deliver effective care and support.

Staff asked people for their consent before delivering care or support and they respected people’s choice to refuse care. The provider was responsive to people’s needs. Staff supported people, and involved them, (as far as they were able), to draw up and agree their own support plan.

The provider worked closely with health and social care professionals to ensure each person received a support package tailored to meet their individual needs. The provider sought people’s feedback and took action to address issues raised. There was a system in place to manage and investigate any complaints

There was a management structure in the service, which provided clear lines of responsibility and accountability. There were effective quality assurance arrangements at the service in order to raise standards and drive improvements.

Further information is in the detailed findings below

The last inspection of the home was carried out on 9 September 2014. No concerns were identified with the care being provided to people at that inspection.

Drakes Place is a 28 bedded service for adults with a learning disabilities or physical disabilities. The home is split into three separate homes (units) with support from one staff team. All areas can be accessed from the main home, however each unit has its own front door and had separate names. The Oaks and Squirrel Park. The main home had 14 beds, The Oaks had five beds and supported people with physical disabilities, Squirrel Park had eight beds and supported people with more complex learning disabilities. The home had the benefit of a hydrotherapy pool. All people living at the home were able to access the pool with support from staff. At the time of the inspection there were 24 people living in the home.

There is a registered manager in post. 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.

The registered manager was appropriately qualified and experienced to manage the home. They had experience of supporting people with learning disabilities and continued to develop further skills and knowledge by ongoing training. The registered manager had managed the home for 14 years. They were supported by an operations manager and two deputy managers. The deputy managers and registered manager were available throughout the inspection.

Darkes Place cared for people with a variety of needs and abilities Some of the people were able to carry out their own personal care and support with prompting from staff. Some people could go out into the community independently, others needed support from staff. A member of the management team informed us “We are all very close, some people have lived here for 30 years, they have arguments, but generally all get on well”. One person said “I have lived here a long time I love it, It’s my home”.

People received care and support from staff who had the knowledge and skills to support them. Staff were visible and attentive towards people they were supporting, noticing when those who could not verbally ask for assistance required help. They responded kindly and compassionately to people, they used objects of reference or signs to ensure they knew what was being requested.

People, relatives and staff and professionals involved in the home were complimentary about the service and spoke highly about the registered manager and deputy managers. One health care professional involved in the home stated people were offered a wide variety of activities. Another health care professional stated there was good communication and staff responded quickly to people’s needs.

Staff spoken with had a clear understanding of what may constitute abuse and how to report it. All were confident that any concerns reported would be fully investigated and action would be taken to make sure people were safe. Safeguarding information posters were displayed throughout the home to ensure people, relatives and visitors and staff had access to information on how to raise issues outside the service if they wished.

Care records were well written and detailed, with formats that supported people’s communication needs. They accurately reflected people’s care and support needs. People were fully involved in their care planning. Care plans included information about people’s likes, interests and background, and provided staff with sufficient information to enable them to provide care

in a non-discriminative way. People signed their care plans to demonstrate they had been involved in reviewing them or agreed to changes made. Staff had a good understanding of each person’s needs and preferences. They received appropriate training to enable them to support people safely and effectively.

Safe systems were in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice. Medicines were stored, administered and recorded safely. Health professionals were routinely involved in supporting people with their health and wellbeing.

People were supported to have sufficient to eat and drink. Menus were available for people to see what was for dinner on notice boards in each part of the home. The main meal was cooked from the kitchen in the main house. There were mixed views regarding the food such as, “Some days I don’t like the food”. “Nice food”. People told us they liked helping in the kitchen and choosing their own sandwiches.

Staff supported and encouraged people to engage with a wide variety of activities and entertainment inside and outside of the home. The activity programme showed the activities were tailored to individual needs and capabilities. There were many examples of staff facilitating real friendships between people living at the home.

Although the majority of people could communicate verbally some had more limited communication or were non-verbal. A deputy manager told us” Some people we support are non-verbal, we try to stimulate people as much as we can. We have improved our sensory room and improved the activities programme to ensure maximum choice is given”.

We considered all the evidence we had gathered under the outcomes we inspected. We used information to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found:

On the day of our inspection at Drakes Place there were 27 people living there. One person was away on holiday. We spoke to eight people living at the home and seven members of staff.

Is the service safe?

We observed people were cared for in an environment that was safe, clean and hygienic. Eight people were able to tell us they were "happy" living at the home. One person said "The staff are wonderful and are more like friends than staff". We noted appropriate safeguarding arrangements were in place in the form of safeguarding and whistleblowing policies.. All staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberties. We saw evidence of this in staff files.

CQC monitors the operations of Deprivation of Liberties which applies to care homes. We were told by the registered manager that two applications had been submitted in line with the appropriate policies and procedures. We were told that relevant staff had been trained to understand when an application should be made and when to submit one. We observed there were sufficient staff on duty to meet the needs of people living at Drakes Place. The registered manager or deputy managers' were on call in case of emergencies. We noted staff records were accurate and complete. We saw evidence that staff had the experience and skills needed to support people in their care at the home. We observed emergency procedures were in place in the event of fire. We noted fire evacuation training was up to date and documented in staff files.

Is the service effective?

We found the service was effective in meeting people's needs. We observed staff at the home interacted well with people. It was evident that staff were well known to people at the home. One staff member said "I chose to come back to the home after I had left to gain experience elsewhere. I came back here because the home is well run and people are given all the time they need to be cared for in a way that meets all of their care and support needs". One person living at the home told us "This place is great and I choose what I want to do with my key worker. This week I am going out to the carnival with all the staff".

Is the service caring?

We reviewed the care records of five people living at the home. We noted each person's care plan contained a comprehensive assessment of their care and support needs which had been undertaken by a senior carer. One person said "Staff help me to choose my clothes for the next day as I go out with the staff at least three times a week". Another person said "My key worker planned my care with me and everything is written down in my care plan". We observed throughout the inspection that staff cared for people with kindness and respect at all times. We noted that staff had a good understanding of each person's care and support needs and treated people with dignity. For example, one person required help to drink their fortified fluids at lunch time. We noted the staff member spent a considerable amount of time gently prompting the person to finish their own drink. This demonstrated that staff were aware of the importance of people maintaining their independence with eating and drinking, but also ensuring an adequate nutritional intake was being maintained.

Is the service responsive?

Staff told us it was essential to the care and wellbeing of people living at the home to be responsive to their care and support needs. We noted the home encouraged people to be as independent as they were able to be. We noted there was a wide range of activities to support people's independence. People's ability to be involved with activities was assessed daily. The registered manager told us that people were encouraged to participate in at least three meaningful activities each week. For example, shopping, horse riding, swimming and gardening. We observed one person who liked to smoke was gently prompted by staff to only smoke outside the home and to be supported by staff. As the person was unable to communicate verbally, the staff used a variety of sign language and body language to communicate with them. This demonstrated that people were able to make personal choices and were supported by staff to maintain their personal safety and the safety of other people living at the home.

Is the service well-led?

We observed that staff had a good understanding of the ethos of the home. Staff demonstrated throughout the visit that people were supported to live and independent lives within their medical condition. One person living at the home told us "I know who the manager is and if I had a problem I know I can always talk to them". We reviewed the feedback from the annual quality assurance review for 2013 completed by people living at the home and their relatives. We noted people had commented favourably on the care, support and management of the service. One relative had said "Thank you for organising my family member's birthday party which they really enjoyed. I can never thank you enough for the love and care your staff have shown my family member".

We noted that staff received regular supervision, appraisal and in- service training. This was recorded in staff files and in the central training records held by the registered manager. This demonstrated that staff were supported to give quality care to people at the home.