CQC report explained · a residential care home
What the CQC found at Derby House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, robust recruitment checks, clear risk assessments, secure medicines and a clean environment. Some protocols for as-needed medicines were not present in all cases.
- Effective?
- Good
- Staff had appropriate training, supervision and appraisals. People received support with food, healthcare and communication, and staff worked effectively with health and social care professionals.
- Caring?
- Good
- Staff were kind, respectful and attentive. People were supported to make choices, maintain relationships, use their private space and develop independence.
- Responsive?
- Outstanding
- Care was highly personalised and people had a wide range of activities and community opportunities. Staff adapted their skills and support when people's needs changed, helping people remain at home.
- Well-led?
- Good
- Inspectors found supportive leadership, good teamwork and effective checks on quality, medicines, incidents, infection control and the environment. People, relatives and staff could give their views.
What inspectors found, October 2019
Rated Good; inspectors found kind, safe care and exceptionally responsive support, with some missing as-needed medicines protocols.
This was an unannounced inspection by two inspectors on 28 August 2019. They observed care, spoke with people, staff, relatives and professionals, and checked care, medicines, training and management records.
The home supported five people with learning disabilities, including autism, in a building for up to eight people. Inspectors found enough suitably trained staff, safe care, good health support, kind staff and effective leadership.
The strongest area was responsiveness, rated Outstanding. People were supported to make choices, build independence, join education or work, take part in many activities and remain at home when their needs changed.
The overall rating was Good. Safe, Effective, Caring and Well-led were also Good. The home was rated Good at the previous inspection, while Responsive improved from Good to Outstanding.
Personalised support
Care plans included people's personalities, preferences, needs and hopes. Staff planned support with people and helped them achieve personal goals.
“Care plans looked holistically at people and were extremely person-centred with detailed information about people's personalities, culture, likes, dislikes and care needs.” from the report
Community life
People were supported to take part in education, volunteering, social enterprises, holidays and many local activities. This helped build confidence, independence and relationships.
“People had exceptional levels of engagement with their local community.” from the report
Kind and respectful staff
Inspectors observed respectful conversations and a caring approach. People were supported to make choices and retain privacy and independence.
“People were cared for by staff who demonstrated a kind and caring approach.” from the report
Safe staffing
There were enough staff for people's assessed support levels, including one-to-one and, where needed, two-to-one support in the community. Recruitment checks were completed.
“There were sufficient staff to care for people living at Derby House.” from the report
Some as-needed medicine protocols missing
needs fixingProtocols explaining when to give some as-needed medicines were not available in every case. The manager was told about this and inspectors expected it to be corrected immediately.
“However, these were not present in all cases” from the report
- 01Have the missing protocols for as-needed medicines now been completed for every person?
- 02How are people's medicines checked, and how are families told about changes to medicines?
- 03How will the home continue supporting people to access education, volunteering, work and community activities?
- 04What specialist training do staff receive when a person's health or support needs change?
- 05How are people and their families involved in updating care plans and making decisions about activities and daily life?
This was an unannounced inspection of all five key questions, including the care, accommodation, records, staffing and management of the home. This explanation was written from the published report of 18 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2017
Derby House was rated Good; inspectors found safe, kind and personalised care, with some work still needed on staff teamwork and activities.
This was an unannounced inspection on 30 January 2017. Two inspectors observed care, spoke with relatives, staff and other professionals, and checked care plans, medicines records, risk assessments, incident records, complaints and audits. People living in the home could not tell inspectors about their experiences directly.
The inspectors found suitable staffing, safe medicines practices and clear guidance about risks. Staff supported people with food, health care, independence, privacy and relationships. Care plans had become more personal and activities had increased, although the home said this work was still developing.
The home had improved since the December 2015 inspection. Earlier concerns about safe care, dignity and quality checks had been addressed. All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led.
Safe staffing and risk management
The home had enough staff to support people both at home and on outings. Staff followed guidance to reduce risks, including choking risks.
“There was a sufficient number of staff to enable people to go out of the home supported by the level of staffing they should expect.” from the report
Kind and respectful care
Inspectors saw staff speaking respectfully and supporting privacy, independence and personal choices. People's individual ways of communicating were understood.
“We found at this inspection improvements had been made as people were given the respect they should expect.” from the report
Personalised support plans
Support plans had improved from the previous inspection. They included people's wishes, communication, preferences and how they liked to spend their time.
“They continued to be very detailed but were written in a more person-centred way and focussed on people's wishes.” from the report
Improved activities
Activities and outings were more regular and were increasingly based on what people enjoyed. The timetable could be changed to suit individual preferences.
“We saw from the records that activities and outings took place much more regularly.” from the report
Management improvements
The new manager had made positive changes and quality checks were being used to identify and address problems. Relatives and staff spoke positively about the change in management.
“The provider had instigated many changes since the last inspection and the new manager had accelerated their implementation.” from the report
Uneven staff teamwork
needs fixingSome staff told inspectors that the working culture was not always good and that some staff carried most of the work. The manager agreed actions, including further training for shift leaders.
“There was not always a good working culture and that some staff took on the majority of the work.” from the report
Residents' meeting information
minorAlthough people were involved in the home, meeting minutes were kept in the office rather than shared in a format people could understand. The manager said this would be addressed.
“The minutes were typed and stored in a file in the office, rather than being displayed in a way that people could understand.” from the report
Activities still developing
minorActivities had improved, but the home said it was still working on giving people more access to meaningful activities that matched their individual interests.
“It was still a work in progress and they would continue to develop people's access to their preferred interests.” from the report
- 01How do you make sure staff workload is shared fairly on every shift?
- 02What training or supervision has been provided to improve staff teamwork?
- 03How are activities chosen for each person, and how do you check that they remain meaningful?
- 04How are residents helped to understand and take part in meetings and decisions about the home?
- 05Has the new manager's application to become registered been completed?
This was an unannounced inspection covering all five key questions and checking whether earlier concerns identified in December 2015 had been addressed. This explanation was written from the published report of 2 March 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Derby House
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- October 2013
Registered with the Care Quality Commission on 3 October 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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