Douglas House

Safe- this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment, we rated this key question good. At this assessment, the rating has changed to requires improvement. We found the service was not always following best practice guidance in relation to the management of medicines. We also found people’s care plans were not always being followed.This meant some aspects of the service were not always safe, putting people at risk of avoidable harm. The service was in breach of legal regulations in relation to safe care and treatment.

Effective- this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life.

We assessed a limited number of quality statements in the effective key question. The scores for this area have been combined with scores based on the rating from the last inspection, which was good. At this assessment, the rating has remained good. This meant people’s outcomes were consistently good.

Caring- this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

We reviewed 1 quality statement within caring. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. The rating for this key question remains good. This meant people were supported and treated with dignity and respect.

Responsive- this means we looked for evidence that the provider met people’s needs.

We reviewed 1 quality statement within responsive. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. The rating for this key question remains good. This meant people’s needs were met through good organisation and delivery.

Well-led – this means we looked for evidence that leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, honest and fair culture.

At our last assessment, we rated this key question as good. At this assessment, the rating has changed to requires improvement. This meant the management and leadership were inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

We found some governance systems were not always effective, and where audits had identified shortfalls, some action had not been taken in a timely manner. The service was in breach of legal regulations in relation to good governance.