Archived: Darley Dale Care Home

Darley Dale is a residential care home providing personal care to 2 people aged 65 and over at the time of the inspection. The service can support up to 13 people in one adapted building

People’s experience of using this service and what we found

We found improvements to how people's care plans and risk assessments were reviewed and recorded to ensure they reflected people's needs.

Improvements had been made to how the registered manger monitored the quality of the service.

The registered manager was aware of which incidents must be reported to CQC when these occurred.

Regular checks were made to ensure the environment of the care home was safe and maintained.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires improvement (published 11 March 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Darley Dale Care Home is registered for 13 people over 65 years of age. At the time of our inspection there were 2 people using the service.

We found the following examples of good practice.

¿ Staff ensured the service was regularly cleaned and the environment was adequately ventilated.

¿ Staff and people had been tested for COVID-19 in accordance with national guidance.

¿ Staff used the PPE provided appropriately.

¿ People were supported to stay socially engaged and not to become lonely. People were supported by staff to have telephone contact with their relatives.

¿ The service had a plan in place to manage any staff shortages during an outbreak of infection.

¿ Recent improvements to the environment of the care home have eliminated the need to use shared bathing facilities which has further reduced the risk of cross infection

¿ Arrangements had been made for visitors to be screened before entering the care home. A covered area has been developed in the rear garden for socially distanced visiting.

¿ The registered manager had kept up to date with current guidelines for infection control during the pandemic.

Darley Dale is a residential care home providing personal care to 2 people aged 65 and over at the time of the inspection. The service can support up to 13 people in one adapted building.

People’s experience of using this service and what we found

Notifications relating to a serious injury to a person and an allegation of abuse had not been submitted to us as legally required.

We found improvements to people’s risk assessments relating to pressure area risk which had had been kept under review, however the quality assurance systems used to monitor the service had failed to identify one person did not have a care plan for their personal needs to support pressure ulcer healing. Accurate records of the care provided to one person had not always been kept.

People’s medicines were generally safely managed although some stored domestic medicines were out of date and this had not been identified.

Regular checks were made to ensure the environment of the care home was safe and maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People's individual needs and wishes were known to staff who had achieved positive relationships with them. People and their representatives were involved in the planning and review of their care. Visitors were welcomed into the care home.

Staff received training to develop knowledge and skills for their role. There were arrangements in place for people and their representatives to raise concerns about the service. The management were visible and accessible to people and their visitors.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (report published 6 June 2019) were we found a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. This service has been rated requires improvement for the last three consecutive inspections.

At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

The inspection was prompted due to information which indicated we had not received a required notification from the service relating to a serious injury. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Responsive and Well-led sections of this full report.

Enforcement

We have identified breaches in relation to notifications about events affecting people using the service and quality assurance systems at this inspection.

Please see the action we have told the provider to take at the end of this report.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: Audits and checks supported the registered manager to identify concerns to improve the service. However, these quality monitoring systems were not always effective in identifying shortfalls in the service provided. When shortfalls had been identified, prompt action had not always been taken to address the risks these shortfalls might pose to people.

Risk assessments relating to people’s care needs had not been kept under review. At the time of our inspection action had not been taken to address a malodour in one room. Following our visit the provider confirmed action had been taken.

People's medicines were safely managed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People's individual needs and wishes were known to staff who had achieved positive relationships with them. People and their representatives were involved in the planning and review of their care. Visitors were welcomed into the care home.

Staff received support to develop knowledge and skills for their role. There were arrangements in place for people and their representatives to raise concerns about the service. The management were visible and accessible to people and their visitors.

Rating at last inspection: At the last inspection the service was rated Requires Improvement (Last report was published on 17 April 2018). At this inspection the rating for this service remains as Requires Improvement. Following the last inspection, we met with the provider and they provided us with an action plan. During this inspection we found some action had been taken however we found additional areas that required improvement.

Why we inspected: This was a planned inspection based on the previous rating at the last inspection.

Follow up: We will again meet with the provider following the publication of this report to ask them what action they will be taking to make the required improvements. We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Darley Dale Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Darley Dale Care Home does not provide nursing care.

Darley Dale Care Home accommodates 13 people in one adapted building. At the time of our inspection visit there were 3 people using the service.

At our last comprehensive inspection 26 February 2016 we rated the service Good. At this inspection we found the service was rated Requires Improvement.

People were not fully protected against risks from receiving care for example a bath hoist had not been recently checked to ensure it was safe to use.

We made a recommendation about the maintenance of equipment and the safety of the environment.

The audit system had not identified risks to people’s safety from equipment and the environment of the care home.

Darley Dale Care home had 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.

People and their representatives made positive comments about Darley Dale Care Home; they appreciated the caring approach of the staff and the atmosphere of a small care home.

We found the environment of the care home was clean. People’s medicines were safely managed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People’s individual needs and wishes were known to staff who had achieved positive relationships with them. People and their representatives were involved in the planning and review of their care. Visitors were welcomed into the care home.

Staff received support to develop knowledge and skills for their role. There were arrangements in place for people and their representatives to raise concerns about the service. The management were visible and accessible to people and their visitors.

Darley Dale Care Home provides accommodation and care for up to 13 older people. At the time of our inspection there were four people living at the home.

Arrangements were in place to report deaths and other important events impacting on people using the service to the CQC through notifications.

At the time of our inspection visit Darley Dale Care Home had 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.

Darley Dale Care Home provides accommodation and care for up to 13 older people. At the time of our inspection there were seven people living at the home.

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.

We had not been notified of some events affecting people living at the home. CQC monitors events affecting the welfare, health and safety of people living in the home through notifications that providers are required to send to us.

People and their representatives made positive comments about Darley Dale Care Home; they appreciated the caring approach of the staff and the atmosphere of a small care home. Their individual needs and wishes were known to staff who had achieved positive relationships with them. People and their representatives were involved in the planning and review of their care. Risks to people’s safety were identified, assessed and appropriate action taken. Visitors were welcomed into the care home. A relative of a person using the service told us Darley Dale was a “nice happy little place”.

Staff received support to develop knowledge and skills for their role. A small staff team worked well together to keep people safe and meet their needs. One staff member commented “we all get along quite well”. The management were visible and accessible to people, their visitors and staff.

We found breaches of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

Care plans were personalised to each individual's needs and from the people we observed we could see that they accurately reflected people’s needs and wishes. Staff we spoke with and observed showed that they had good knowledge of the people they supported. They were seen responding to each person respectfully, with good humour and in a manner appropriate to each individual’s needs.

There were enough qualified, skilled and experienced staff to meet people’s needs. Care was provided in an environment that was suitably designed and adequately maintained. The home was a family run business and the provider and managers lived close by and often stayed on the premises. We could see that there was an open relationship with the managers and people living in the home. We saw that people were comfortable airing their views about the home and were actively involved in discussions about any changes to the service.