Danebank

Updated 21 February 2024

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 carried out by 2 inspectors.

Service and service type

Danebank 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. Danebank 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 not a registered manager in post. A manager was in post who intended to apply to register with CQC.

Notice of inspection

We gave the service 24 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.

Inspection activity started on 9 January and ended on 22 January 2024. We visited the location’s service on 9,16, 18 and 22 January.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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

Not all the people who lived at Danebank were able to fully express their views and experiences, so we observed the care and support they received. We also spoke with 3 family members, the nominated individual, the manager, a senior support worker and 6 support workers. We reviewed 3 people's care records and medication records. We also reviewed a range of records relating to the management of the service, including staff recruitment records policies and procedures. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 21 February 2024

Danebank is a residential care home providing accommodation for persons who require nursing or personal care, up to a maximum of 4 people. The service provides support to people with a learning disability and/or autism. The service consists of a detached house with an Annex building to the rear. At the time of our inspection there were 3 people using the service.

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:

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Where some restrictions had been put in place to manage risk, best interest decisions had not always been recorded and reviewed.

Significant repairs due to damage, and cleaning were required within a particular area of the service. The provider had not acted in a timely way to ensure the environment was currently clean and properly maintained. Systems in place to ensure the safety of the environment needed to be more robust. Whilst maintenance and various checks were carried out, there were some gaps and actions required. The manager agreed to address this straight away.

Systems to ensure staff had undertaken all relevant training and received an appraisal were not sufficiently robust. Staff received an induction and various other training was offered, as well as regular supervisions. However, some staff had not completed all the relevant training and annual appraisals had not been carried out.

Overall, people received their medicines safely. However, records relating to the use of “as required” medicines needed to be more specific. The provider had a policy for infection prevention and control. However, they had not ensured staff were fully following guidance in relation to the use of PPE.

There had been some staff changes but there was a consistent team of staff, who knew people well. Agency staff were used to fil any gaps and processes had changed to ensure these staff were as consistent as possible. Staff were recruited safely.

Right Care:

People appeared to be at ease and looked comfortable with the staff. Relatives told us their loved ones seemed safe and well cared for. The provider was working closely with other health and social care professionals, where there were concerns about the most appropriate care and support for a person.

Overall, people's needs and risks were assessed. Staff understood how best to support people. However, risk management information for one person needed to be more reflective of their current changing needs. Care records were in different formats for each person and were difficult to navigate. The new manager was in the process of reviewing these and implementing new care plans.

Right Culture

Overall, there was a positive culture and staff worked in a person-centred way. However, relatives felt they could be better involved in planning and reviewing their family member’s care. There were no restrictions on visiting. The provider had a positive behaviour support team to help support people and staff with their approach.

There were systems for oversight, but these were not always effective in ensuring all areas for improvement were identified and actioned in a timely way and accurate records were being kept.

Staff had undertaken training in safeguarding and understood their responsibility to safeguard people. However one incident had not been reported under local procedures as required. The provider had not ensured CQC were notified of certain events as legally required. There was a new manager at the service. Staff felt supported and able to raise any concerns. The management team were responsive to feedback and had started to take some action to make 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 last rating for this service was good (published 5 September 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified 4 breaches in relation to consent to care, the premises, systems to monitor and improve the quality and safety of the service and notifying CQC of certain events.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.