Archived: Da-Mar Residential Care Home

Below is a summary of what we found. The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

When we last inspected on 11 April 2014 we had found that people's needs had been appropriately assessed before they were admitted to Da-Mar. We also found that people's needs had been regularly reassessed to ensure they received the safe care they needed.

When we visited on 22 May 2014 we found one person that walked with a mobility aid had recently had a fall which had resulted in admission to hospital for a short period. We looked at this person's care records and saw that risk assessments were in place but they did not state what precautionary measures staff should take when the person was climbing up or down the staircase to their bedroom. This meant that care was not always planned in a way that was intended to ensure people's safety.

We saw that the provider had taken action to ensure that people were not at risk of scalds from water that was too hot. This was as a result of an accident where a person had received a scald whilst being showered. We were concerned that an investigation by Northampton Borough Council's Health & Safety Team had found that the provider had not ensured that there was effective equipment in place to safely regulate the water temperature when the shower was used. As a result of this information of concern we have taken enforcement action.

There were suitable arrangements in place to respond to emergencies. We noted there was always a designated senior member of staff available 'on call' to support staff to manage an emergency situation safely and in a timely way. There were effective security measures in place to ensure the premises were protected from unauthorised entry by people who had no legitimate cause to be in the home. People arriving at the home were visible on camera in the manager's office, and visitors were asked to sign the visitors' book when they entered the building.

Is the service effective?

We saw that healthcare professionals, such as GPs and community based nurses, visited the home regularly to monitor people's health or provide them with essential treatment. When we visited on the 22 May 2014 we saw the staff handled an emergency situation when a person became ill in a calm, effective manner. We saw that the staff had called the GP promptly. This meant that people received the safe care they needed when they became ill or their health had deteriorated and they required timely medical intervention.

When we spoke with staff and looked at records, we found that they had received the information, training and managerial support they needed to do their job effectively.

When we spoke with staff on 11 April 2014 and again on 22 May 2014 and observed them going about their duties, we concluded that they had a good knowledge of each person's care needs and preferences.

Is the service caring?

When we visited on 11 April 2014 we saw that staff were patient and kind. When we again inspected the home on 22 May 2014 we heard staff encourage people who struggled to do things for themselves. We saw staff were helpful and considerate.

Is the service responsive to people's needs?

One person we spoke with said, 'The staff treat me very well.' A visitor we spoke with said they were happy with the care their relative received from staff.

When we inspected on 11 April 2014 we saw that there was enough staff on duty to meet people's needs. When we again inspected on 22 May 2014 there were sufficient numbers of staff on duty. The visitor and healthcare professional we spoke with said there were always enough staff around to attend to people.

Is the service well-led?

The three staff we spoke with said the manager was supportive and approachable. They said they were encouraged to go to the manager if they were unsure about anything or were concerned about a person's health or well-being.

We had some concerns about the arrangements in place to induct agency staff that sometimes had to be used to supplement staffing numbers, particularly at night. We found that there was a lack of documentation to evidence that agency staff had received the information they required about people's needs and had been given clear direction on their duties during their shift.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

People's needs had been appropriately assessed before they were admitted to Da-Mar. We found that people's needs were regularly reassessed to ensure they received the safe care they needed. This meant that staff had the up-to-date information they needed to minimise identified risks to people's safety and welfare.

We saw that people were cared for in an environment that was clean and hygienic. We found that the equipment in place for staff to use to support people with their care needs was appropriately maintained.

There were suitable arrangements in place to respond to emergencies. We noted there was always a designated senior member of staff available 'on call' to support staff to manage an emergency situation safely and in a timely way.

We saw that there was effective security measures in place to ensure the premises were protected from unauthorised entry by people who had no legitimate cause to be in the home, as a visitor or tradesperson. People arriving at the home were visible on camera in the manager's office, and visitors were asked to sign the visitors' book when they entered the building. This meant that people felt safe living at Da-Mar.

Is the service effective?

Where people's ability to choose had been compromised by their dementia, we saw there was appropriate information about their care needs and abilities. This demonstrated that staff had sufficient guidance to enable people to express themselves and make their feelings and wishes known.

When we spoke with staff and looked at records, we found that they had received the information, training and managerial support they needed to do their job effectively.

We spoke with staff and observed them going about their duties and we concluded that they had a good knowledge of each person's care needs and preferences. This meant that people's needs were effectively met at Da-Mar.

Is the service caring?

When we saw staff interact with people their manner of approach was patient, kind, and good humoured. They encouraged people who struggled to do things for themselves. We saw that staff, although busy, were purposeful and unhurried so they had not 'rushed' people to do things. One person described the staff as "very patient and always ready to help."

Is the service responsive to people's needs?

We spoke with three care staff and found they each had a good understanding of how to support people in a way that respected each person as an individual, each with their own needs and wishes.

We saw that there was enough staff on duty to meet people's needs. This was also confirmed by the three staff, two visitors, and four people we spoke with.

Is the service well-led?

Staff said they received a good level of practical day-to-day managerial support to enable them to carry out their duties. They said that the manager was very approachable and fair, and encouraged them to come up with creative ideas for improving people's quality of life. We saw, for example, that people were actively encouraged to make use of the enclosed garden during fine weather. The manager said that people were involved in choosing seasonal plants and flowers so that the garden was attractively stocked and gave people pleasure.

The manager had ensured there were effective quality assurance processes in place so that the quality of the care people received on a daily basis was effectively monitored. Regular daily checks were made throughout the day by staff to ensure that people had consistently received the safe care they needed in a way that suited them.

One person commented, 'The carers are always asking me if I like things or want to do things, but I am quite content. It is nice to be asked though.'

We spoke with three staff members that worked at the service. They all told us that they felt well supported in their roles and that they thought that people received a good standard of care.

We found that people's dietary needs were accommodated and that the kitchen staff had good knowledge of people's dietary needs. We found that people were protected from using unsafe or unsuitable equipment.

We had concerns that actions were not taken to prevent falls in a timely manner and about the way in which we observed medication being administered. We also had concerns that all staff had still not received appropriate supervisions and appraisals.

We spoke with a relative of a person who used the service who told us that they were always kept informed about their relative's care.

We spoke with three staff members who all told us that they felt well supported and that there were enough staff on duty to meet people's needs.

We found that the cleanliness of the home had improved and that it was being regularly monitored. We found that staffing levels were sufficient to meet people's needs and that people's care plans were consistent.

We had concerns that staff appraisals had not been carried out and that not all of the staff were receiving regular supervision. We saw that a general team meeting had been held where staff had been given an opportunity to discuss any issues.

Staff members who worked at the service told us that enjoyed work and that the best thing about the home was the people who lived there.

People who used the service told us they liked living at Da Mar Residential home and that they felt safe.

We found detailed care plans for people who used the service but had concerns about the cleanliness of the home and the staffing levels.