Danebank

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.