Dene Park House

Effective safeguarding procedures were in place to protect people from the risk of abuse. Staff had received safeguarding training and demonstrated a good understanding of how to protect people from harm or abuse. Staff effectively assessed, monitored and managed risks to people’s personal safety and wellbeing. Care plans were in place to mitigate risks and were regularly reviewed. Equipment was safe and well maintained. The registered manager ensured staff were trained to use equipment and understand how to check items were safe to use. The premises were safe and mostly well-maintained, but some areas of the home needed redecoration to ensure effective cleaning. Staff followed appropriate infection control procedures. Fire safety was well-managed, and arrangements were in place to support people in the event of an emergency. Systems were in place to ensure incidents and accidents were reported, recorded, investigated and any lessons learnt were used to reduce risk of re-occurrence. The provider and registered manager understood their responsibility under the duty of candour and how to respond. Staff recruitment was undertaken safely and significant improvements had been made to the recruitment records of new staff. Staff received an induction and training relevant to their roles and responsibilities. They were supported through regular supervision and appraisal. Staffing levels and deployment received mixed reviews from people, relatives and staff. We shared this with the registered manager to consider when determining their staffing levels and skills mix to ensure people received consistently safe, person-centred care. Medicines were better managed, although further improvements were needed to records. Staff were knowledgeable about people’s medicines and were suitably trained. Staff worked closely with external professionals to ensure people had safe transitions between services.

People’s needs were assessed with them prior to moving into the service and reviewed on an ongoing basis to ensure their needs were met. People’s care was planned and delivered in accordance with their preferences and in line with best practice guidelines. Staff supported people’s health and wellbeing to ensure they experienced positive outcomes from the care the service provided. Staff worked well as a team and with other health and social care professionals to ensure people received consistent care and support which met their needs. Staff understood the principles of the Mental Capacity Act 2005 and sought consent from people before delivering care.

People confirmed they were involved in decisions about their care and were supported to express their views and have as much control in the delivery of their care, as possible. Relatives or advocates were involved in decision making where appropriate.

Staff supported people to manage their health and wellbeing in ways which promoted their independence, choice and control. People were supported to participate in culturally relevant, inclusive and diverse activities which were meaningful to them.

People found staff were caring and treated them with respect. They spoke positively about staff but also said that they were busy and not always able to interact. Staff encouraged people to maintain relationships that were important to them and relatives could visit whenever they wanted.

At the last inspection we found the provider was in breach of regulation 17 as some people’s care plans lacked person-centred information and the necessary guidance to enable staff to support them as an individual. At this inspection the provider was no longer in breach of regulation 17.

Staff understood the importance of delivering person-centred care and were responsive to people’s individual needs and preferences. Staff supported people to access services they may require, to ensure additional care and treatment needs were assessed and met.

Information was provided in appropriate, accurate and up-to-date formats that could be tailored to individual needs. Systems in place made it easy for people to share feedback and ideas or raise complaints about their care and support.

Procedures were in place to support people to plan and make informed decisions about their future, including at the end of their life. Care plans were person centred, provided relevant detail to assist staff to deliver appropriate care and were regularly reviewed.

The premises were accessible for those people requiring reasonable adjustments and people were enabled to access non-healthcare related services on a regular basis.

At the last inspection the service was not meeting all the legal requirements of regulation 17, good governance. At this inspection the service was no longer in breach of this requirement as improvements had been made. Governance systems were in place which had been effective in driving improvements. However, the process for auditing medicines, the environment and infection prevention and control failed to identify the concerns we found during the assessment.

The provider worked with the registered manager and staff to promote a shared vision, mission and values. The registered manager fostered a positive culture where people and staff felt confident they could speak up and that their voice would be heard. Mechanisms were in place to facilitate this. The provider had systems in place to ensure an inclusive and fair culture was created, which consistently looked at how to improve equality and diversity for the people they supported and their workforce.

The registered manager understood the legal requirements and importance of their role and responsibility. They understood their duty to collaborate and work in partnership. They shared information, and learning with partners, and collaborated for improvement, when needed. Staff had developed good links with the local community and worked in partnership with other agencies to improve good outcomes for people.

The provider ensured there was a system in place to encourage continuous learning, innovation and improvement across the service. The service had comprehensive policies in place to support the registered manager and staff to achieve this. Staff were passionate about providing good quality care for people. They told us there were plenty opportunities for training and personal development.