About the service: Dearman Road is a respite service offering accommodation and support for people with mental health support needs. Two people were supported at the time of the inspection.

People’s experience of using this service:

Staff showed awareness of people’s safety and risks, and demonstrated a caring approach. A person we spoke with told us they felt safe. They spoke positively about the service and the support of staff. People’s privacy and independence was promoted. People were given choices and support to access further support from their mental health teams when needed. However, the provider’s systems failed to ensure the quality and safety of the service with particular concerns as follows:

• People’s risks had not been effectively assessed, including in relation to ligature risks at the premises. The provider’s environmental risk assessments had not been completed robustly and action to improve the safety of the service had not been completed to the provider’s own timescales.

• Health and safety checks were not completed robustly to ensure the safety of the service including in relation to fire safety.

• Incidents were not effectively investigated and used for learning to improve the safety of the service.

• Please see more in Detailed Findings below.

Rating at last inspection: Requires Improvement (November 2017)

Why we inspected: This was scheduled inspection based on the previous inspection rating.

Enforcement We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment and governance. We also identified a breach of the Care Quality Commission (Registration) Regulations 2009. Details of action we have taken can be found at the end of this report.

Follow up: During our inspection, we prompted the provider to address our safety concerns and to provide us with updates after the inspection. We shared our concerns with the local authority and commissioning team that arranges referrals to the service. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this registered provider is ‘Inadequate’. This means that it has been placed into ‘Special Measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration, if we have not taken this enforcement action already.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or varying the terms of their registration within six months if they do not improve and similar action may have been taken already. This service will continue to be kept under review and, if needed, could be escalated to further urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

This inspection took place on 24 August 2017 and was unannounced. This is the first time we have inspected this service since it was registered in May 2016.

Dearman Road is a respite service offering accommodation and support for a maximum of five people with mental health support needs. At the time of our inspection, two people were using the service. There was a registered manager in place who was present during our inspection. 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.

A person told us they felt safe using the service. People were often supported by lone workers who had been suitably recruited. Staff escalated any concerns about people’s health and were aware of safeguarding procedures to help protect people. Planned processes were not always followed however to ensure people’s risks were always effectively monitored.

A person and a healthcare professional told us they were satisfied with the support people received with their medicines. All medicines records and processes were not always clear to support safe and consistent practice.

People made their own choices and prepared their own meals, with support available from staff if needed. Staff supported people as needed during their stay. Staff found the induction helpful and training was being updated. People were signposted to local health services and attended review meetings with their community healthcare teams to help promote their health and recovery.

People could engage with staff about their progress and express their views about the support provided if they wished. Monthly meetings for people were not held as planned however to always allow people further opportunity to share feedback and receive information about the service.

People using the service had the privacy they needed and were treated with respect. People’s independence was encouraged.

There were systems in place to help people share feedback. One person’s feedback had been addressed during their stay and there were systems in place for people to offer compliments or raise complaints. The registered manager told us no formal complaints had been made about the service since its registration.

People received a service that was responsive to their needs. There was a registered manager in place and support mechanisms for staff and the existing service project leads. Systems and processes to help ensure and drive the quality and safety of the service were not always followed as planned.