Darsdale Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Darsdale Home accommodates up to 30 older people in a converted building which has two floors. Most of the bedrooms and all communal areas were based on the ground floor. At the time of our inspection there were 27 people staying there.

At our last inspection in August 2017 the service was rated as overall ‘Requires Improvement’. Although we found there have been some improvements at this inspection we found there were areas that still needed to improve, so overall the service remains rated as ‘Requires Improvement.’

The service did not have a registered manager, however, a manager was in place who was in the process of completing their application to become the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received care from staff who were kind, compassionate and respectful. However, the care was task focussed and there was limited interaction with people outside of completing care tasks.

People’s needs were assessed prior to coming to the home and detailed care plans were in place, however, these did not always reflect the current care needs of people. Risks to people had been identified and measures put in place to mitigate any risk but staff were not always aware of the risks and did not follow the guidance given.

The systems in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of people using the service had not been consistently kept.

Staffing levels had improved but needed to be maintained and account taken of people’s needs outside of basic care and mobility. There was a high usage of staff from a staffing agency which had impacted on the consistency and standard of care delivered.

Staff were supported through regular supervisions and undertook training which helped them to understand the needs of some of the people they were supporting, training needed be widened to cover the needs of a diverse group of people.

There were appropriate recruitment processes in place and people felt safe in the home. Staff understood their responsibilities to keep people safe from any risk or harm and knew how to respond if they had any concerns.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People’s health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people’s care.

People were cared for by staff who were respectful of their dignity. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

The manager was approachable and people felt confident that any issues or concerns raised would be addressed and appropriate action taken.

The service strived to remain up to date with legislation and best practice and worked with outside agencies to continuously look at ways to improve the experience for people.

This inspection took place on the 30 June and 5 July 2017. Darsdale Home is a residential care home providing accommodation and care for up to 30 people. The service supports people living with dementia as well as people who have a learning disability or acquired brain injury. At the time of our inspection there were 28 people living in the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were not enough staff to meet all of people’s needs. Although people’s physical needs were met the staff were under too much pressure to provide for people’s well-being with less positive engagement and activities than people needed. The provider and registered manager were aware of the shortfalls in relation to the deployment of staff however, appropriate timely action to mitigate the impact of the staffing levels on people in the home had not been taken.

This was a breach of regulation and you can see what action we told the provider to take at the back of the full version of this report.

People were protected from the risk of harm because staff were confident in the steps that they should take to safeguard people. Risks to people had been assessed and plans of care were in place to manage the known risks to people. People could be assured that they would receive their prescribed medicines safely.

People were supported by staff that had access to regular supervision and training that was relevant to their role. People were supported to access healthcare services and to maintain adequate nutrition and hydration.

Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS) and had applied that knowledge appropriately. Staff understood the importance of obtaining people’s consent when supporting them with their daily living needs.

People’s care needs were met in line with their individual care plans and assessed needs.

People knew how to make a complaint or raise a concern about their care and support. Where the registered manager or provider had been alerted to complaints there were clear procedures in place for their management and complaints were responded to quickly.

The provider and registered manager were accessible to people and staff. They were committed to improving the care and support that people received.