We carried out a review of the data available to us about Drumconner Lancing on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Drumconner Lancing, you can give feedback on this service.
Drumconner - Lancing is situated in Lancing, West Sussex and is one of two homes owned by the provider, Drumconner Limited. Drumconner – Lancing, accommodates 57 people over two floors. There was a range of rooms of different sizes to meet people’s preferences, with most rooms having ensuite shower facilities. There were two communal lounges, a large communal dining room and a coffee bar area. There were also attractive and accessible gardens for people to enjoy, as well as a hairdressing room. The home provides accommodation for older people, those living with dementia and people who require support with their nursing needs. At the time of the inspection there were 47 people living at the home. The home had a 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.
At the last inspection the home was rated as Requires Improvement. The provider was found to be in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe, Effective, Responsive and Well-led to at least good. This was because there were risks to people’s safety as staff did not always implement external healthcare guidance. Medicines administration was not always safe. Staff had not always adhered to the legislative requirements when gaining people’s consent or placing restrictions on their lives. Not all people had access to stimulation or interaction with staff. There had been ongoing changes in the leadership and management of the home. At this inspection it was evident that the provider had followed their actions plan and improvements had been made. The provider was no longer in breach of the Regulations.
People told us that staff made them feel safe. Risks were assessed and managed well. One person told us, “I feel safe as there are lots of carers who look after my health, my personal care, my food and my medicines. They help me to enjoy my day with interesting activities”. I couldn’t do it all on my own anymore. I don’t have to worry”.
People felt that there was sufficient staff, that they were well-trained and knowledgeable to meet their needs and assure their safety. People and staff were aware of the importance of raising concerns about people’s wellbeing and safety. People were protected from abuse and made aware of their right to complain.
People were protected from the spread of infection. Registered nurses and external healthcare professionals ensured that people’s heath was maintained. Medicines were provided when people required them. People told us that they were confident that staff would summon assistance if their health condition deteriorated. There was a coordinated approach to people’s healthcare. People received good need of life care.
People had a positive dining experience. They told us that they were happy with the food and had access to drinks and snacks throughout the day and night. One person told us, “I enjoy the food and we have a good choice. If you don’t like the menu they will offer an alternative”.
People were asked their consent before being supported and were involved in their care. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff demonstrated respect. People’s privacy and dignity were maintained and they were supported by staff in a sensitive and dignified way. People told us that they felt well-cared for. They spoke fondly of the staff and person-centred practice was evident. One person told us, “They are wonderful, they are kind and considerate in their approach”. A relative told us, “They use their heads, their hearts and their hands like natural carers, you cannot fault them”.
The environment provided spaces for people to enjoy time on their own or with others. There was a fun, lively and welcoming atmosphere. People had access to a varied range of stimulation. Activities, external events and entertainment was available for people to enjoy. One person told us, “I am looking forward to strawberries and cream in the garden later in July. I love the garden”. A relative told us, “I don’t think they get bored like they do in some care homes. I often see a carer sitting with a resident who is alone to have a chat”.
People and relatives were complimentary about the leadership and management of the home. They told us that the home was well-organised and that the registered manager listened and acted upon their ideas and suggestions. Systems were monitored to ensure they were effective. Staff were appropriately supported and involved in decisions that affected their work. Partnership working with external organisations and healthcare professionals ensured that good practice was shared. A relative told us, “Everyone seems happy here. It is a happy home”.
Drumconner Lancing provides nursing support for up to 57 older people, some of whom have physical disabilities or are living with other conditions such as diabetes and dementia and who may need support with their personal care needs. On the day of our inspection there were 46 people living at the home. The home is a large property, with attractive gardens, situated in Worthing, West Sussex, on the south coast of England.
The provider of Drumconner Lancing, also owns another home in the south west of England. The home had a registered manager, however we were informed at the inspection that the registered manager had left employment. A registered manager is a ‘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 home is run. The management team consisted of a clinical lead, who was the registered manager of the provider’s other home and a manager. Subsequent to the inspection we were informed that both the clinical lead and the manager had left employment.
We carried out an unannounced comprehensive inspection on 18 November 2015. Areas in need of improvement were found, these included a lack of meaningful, person-centred activities and stimulation for people and a lack of access to staff training in relation to peoples’ specific needs. Breaches of legal requirements were found in relation to a lack of notifications submitted to CQC with regard to events that had occurred within the home and a lack of detail within peoples’ records to confirm the support that had been provided. Following the inspection the provider wrote to us to say what they would do in relation to the concerns found. At the inspection on 27 March 2017 we found that significant improvements had been made in relation to these areas. However, despite this we found areas of practice that were in need of further improvement.
People told us that they felt safe. One person told us, “Oh yes, I’ve felt safe. The accent is on safety here”. Risk assessments related to some peoples’ needs were in place to ensure that people were provided with safe care. However, not all risks, specific to peoples’ needs had been considered.
Medicine records raised concerns as not all people had access to medicines when they required them. There were concerns with regard to the administration and storage of some medicines. For example, some people who self-administered their own medicines did not have a secure way of storing their medicines and this posed a potential risk to their own and others safety as people, for whom the medicine was not prescribed, may have come into contact with it. One person, who had been assessed as having swallowing difficulties, had been prescribed a thickening agent to be added to their drinks. There were concerns with regard to the person’s safety as observations showed them to have access to un-thickened drinks as well as the thickener itself and the person was at risk of choking and asphyxiation. The administration and access to medicines as well as the management of risk to peoples’ safety were areas of concern.
People were asked their consent before being supported. However, when people lacked capacity to make specific decisions relevant people had not been consulted when decisions were made on their behalf. Necessary applications, for some people who were being deprived of their liberty, had not always been undertaken.
People had access to a range of activities and were complimentary about the activities on offer. One person told us, “There is plenty going on and we have choice to join in or not. We enjoy the quizzes and we like the entertainers who come in. We always have a cake on our Birthdays”. However, there was a lack of engagement and stimulation for people who were less able to take part in activities and there was a risk that some people were socially isolated.
There was mixed feedback with regard to the staffing levels. Observations and records demonstrated that there were sufficient staff to meet peoples’ needs, however, some people told us that there was not always enough staff. One person told us, “No, there are not enough staff, they are over-stretched”. People’s comments were fed back to the management team to enable them to reassess staffing levels. People were protected from harm and abuse. Staff were skilled and experienced and had undertaken the necessary training to enable them to recognise concerns and respond appropriately.
People had access to external healthcare professionals when they were unwell and advice and guidance provided by the professionals had been implemented in practice. One person told us, “Without question, they would call the doctor if needed. I have had a pressure sore and it’s on the mend”. People told us that they were happy with the food and drink provided and observations showed that people had a positive dining experience with a varied range of food and drink that they could choose from. One person told us, “Someone comes round to ask us what we want for lunch and supper the next day. We have our meals here or in the dining room. We have the choice”.
Care plans documented peoples’ needs and wishes in relation to their social, emotional and health needs and these were reviewed and updated regularly to ensure that they were current. People were complementary about the care they received. They told us that the staff were kind and caring and our observations confirmed this. Comments from people included, “The staff are marvellous, they’re very friendly towards me” and “I find the staff very helpful and long suffering. They are all very polite and efficient”. People told us that staff were respectful of their privacy and dignity and our observations confirmed that people were treated in a sensitive and respectful manner. People, if this wished, could plan for care at the end of their life and were able to stay at the home until this time.
The manager welcomed and encouraged feedback and used this to drive improvement and change. There were quality assurance processes in place to enable the manager and clinical lead to have oversight of the home and to ensure that people were receiving the quality of service they had a right to expect. People, relatives and staff were complimentary about the leadership and management of the home.
The inspection took place on the 18 November 2015 and was unannounced.
Drumconner Nursing Home provides nursing support for older people, some of whom have physical disabilities as well as other conditions such as diabetes and dementia. The service has been established for over 35 years and can accommodate up to 57 people. On the day of our inspection there were 46 people living at the home. The home is a large property situated on the south coast.
The service had a 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. The registered manager was not available on the day of our inspection. The service had a manager who was responsible for the day to day running of the home, they had been in post since July 2015.
Consent was gained before supporting people with any tasks, staff were observed asking people if they needed support and how they wanted to be assisted. People were happy with the support provided, one person told us “It’s marvellous and the staff are wonderful, they do anything for you.” For people who lacked capacity the home had followed correct practice by undertaking mental capacity assessments and had made applications for the deprivation of liberty safeguards. However they had failed to notify the CQC about the authorisations for the deprivation of liberty safeguards, this is required to ensure that CQC have oversight and can assess that appropriate action has been taken. This is an area of concern.
People at risk of developing pressure ulcers had been assessed and plans put in place to either liaise with relevant external professionals or treat the pressure ulcer by providing nursing care at the home. However there was insufficient monitoring and recording of pressure area care for people who had pressure ulcers or were at risk of developing them. Staff were not recording information in care records to state when dressings had been changed or when people had been supported to reposition to reduce the effects of pressure.
The lack of effective records to ensure that staff were aware of each other’s actions and people’s condition monitored for improvements or deterioration was an area of concern.
People were happy with the choice and quality of food. One person told us “It’s rather nice, we are fed well and they help if you need it.” People had their nutritional needs met, however for people at risk of malnutrition there were insufficient systems to record a person’s hydration and nutritional intake on a daily basis and therefore there was a lack of oversight of what people were consuming.
Peoples health needs were assessed and relevant health professionals were involved to ensure that people’s health needs were met. However for people who had long-term health needs such as diabetes there was a lack of monitoring and planning around how to manage the condition.
People were supported by trained nurses and care staff who had received basic, mandatory training and who had achieved or were working towards Diplomas in Health and Social Care. However staff had not received training to meet people’s specialist needs such as diabetes, dementia or wound care. Therefore people’s health and well-being could have been compromised as staff had not been given the relevant skills or knowledge to recognise changes in people’s conditions in relation to certain health conditions. This is an area that needs to be improved.
People were able to be take part in activities, however felt that these didn’t always meet their needs and interests. Within a person’s responses to a questionnaire they said “It is very difficult to provide such a wide range of activities to meet everyone’s preferences, perhaps we could have more puzzles, quizzes or listening to music.”
Person-centred plans were in place to ensure that each person received care and support that was specific to them. People were able to continue to live in a way that they chose and their likes and interests were taken into consideration when supporting them. People’s needs were documented in individual care plans, these had been reviewed by nursing staff to ensure that they were current and up to date. However people were not involved in the reviewing of care plans.
We have made a recommendation regarding the involvement of people in the care planning process.
People and staff were complementary about the management and feedback had been gained through the use of annual questionnaires. The quality of the service was monitored by the manager to ensure that it was effective and meeting people’s needs. Regular audits had taken place and actions taken in response when improvements were needed. However these audits had failed to identify the shortfalls in record keeping. This is an area that needs improvement.
People felt safe living at the home and were cared for by sufficient numbers of staff, both nursing and care staff had undergone appropriate checks to ensure that they were safe to work within the health and social care industry. Staff were aware of what actions they needed to take if there were concerns over a person’s safety and had received training in relation to safeguarding adults at risk. Staff received regular observed supervisions where nursing staff and managers observed their practice to identify areas of improvement. There were also annual appraisals for staff to help identify training and development needs.
People were able to take measured risks to ensure that their freedoms were not restricted and their independence maintained. Some people had kettles and fridges in their rooms so that they could have access to drinks and snacks when needed. People’s physical needs were met as they had access to appropriate equipment to ensure that they could mobilise independently throughout the home. One person had a mobility scooter so that they could continue to access the local shops. Risk in relation to infection was minimised as the home was clean and tidy and had safe systems in place to ensure that infection control was maintained.
People said that they received their medicines on time and were offered pain relief if they were experiencing discomfort. Nursing staff dispensed and administered medication and there were safe systems in place for its storage and disposal.
People were cared for by kind and compassionate staff. People told us that their dignity and privacy were respected at all times and staff were observed knocking on people’s doors before entering to ensure that their privacy was maintained. People were involved in the running of the home, there were regular meetings so that people were able to make their views known, records showed that these had been listened to and action taken as a result. Staff adapted their communication to meet people’s needs, one relative told us “The staff are very kind and caring my relative cannot wear hearing aids because they caused ear infections, however staff make sure they talk in their good ear so they can hear.”
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People are treated with respect and dignity by the staff. People who used the service told us they felt safe. A relative told us 'We have the peace of mind knowing that mum is safe here and being well cared for.'
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.
The registered manager sets the staff rotas, they take people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helps to ensure that people's needs are always met.
Policies and procedures are in place to make sure that unsafe practice is identified and people are protected.
Is the service effective?
People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs.
People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely.
Visitors confirmed that they were able to see people in private and that visiting times were flexible.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A person commented, 'It's lovely here and everyone is so kind and helpful but obviously I'd still rather be at home'. A relative said, 'We visit regularly and really can't fault it here. Mum as everything she needs and the staff are wonderful and so patient.'
People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Shortfalls or concerns were raised in the survey and these were addressed.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. One person using the service told us 'They couldn't do more for us and everything I need is here.'
Is the service responsive?
People had the opportunity to take part in a range of activities in and outside the service regularly. The home has its own adapted minibus, which helps to keep people involved with their local community. The activities co-ordinator told us 'I speak to everyone individually when they come in and find out their interests and how they like to spend their day. I will always try and introduce activities that people have requested and that reflect their preferences.'
People knew how to make a complaint if they were unhappy. Two people said that they had made a complaint and both were satisfied with the outcomes. We looked at how these complaints had been dealt with, and found that the responses had been open, thorough, and timely. People can therefore be assured that complaints are investigated and action is taken as necessary.
Is the service well-led?
The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.
The comments of people who used the service included 'I am treated well', and 'I get help when I need it.' Relatives we spoke with told us that people were treated with respect and that staff responded well when things were discussed with them. One relative told us 'Carers are on the ball. They love their residents.' It was the experience of most people who we talked to that they received good care. People consistently told us that they were offered choices in how their care was provided. One person told us 'You get up and go to bed the time you want. They ask what you want for breakfast and if you want it in your room or the dining room.'
Most people who lived at the service had nursing needs, including complex nursing needs. Care and nursing staff we spoke with were knowledgeable about the individual preferences and needs of people they supported. We saw that care staff communicated with people in an appropriate and kind manner, and many of the relatives and people who used the service who we talked with confirmed this.
People were provided with a choice of food and drink. We saw that people were offered and provided with regular drinks and snacks throughout the day. However for three people assessed by the service as being at high risk of malnutrition there was a lack of care planning, weight and food and fluid intake records, in order to confirm that they had been fully supported to receive the nutrition they needed. Therefore it could not be confirmed that the appropriate actions had been taken to maintain their health and wellbeing.
We found all areas of the service to be clean and there were no strong odours. Improved arrangements had been put in place in the laundry room to assist in the control of infections.
Records we looked at showed that checks and references were obtained for new members of staff before they commenced unsupervised work at the service.
Most people who we talked with said that managers and staff dealt with their complaints fairly and effectively. There was a complaints procedure in place, but at inspection the service was not able to provide us with a summary of the complaints they had received or other evidence that the complaints procedure had been followed. This meant that it could not be shown that the provider had responded to and resolved where possible any comments or complaints.
We found that care and treatment records in the home were not always accurate and up to date. For example, plans of action and records relating to one person's diabetes and another person's pressure area care had not been fully completed, and therefore the people concerned were at risk of not receiving safe and appropriate care and support.
The only complaint that people raised with us during our visit concerned the length of time that they perceived they had to wait for their call bells to be answered. Staffing levels at the time of our inspection were sufficient for the number and needs of people accommodated. The provider had recently installed a new call bell system which enabled response times to be monitored and as such this issue was referred back to them to evaluate.
We found care records to be comprehensive and up to date which meant that staff had access to the right information to provide care appropriately.
We found communal areas and bedrooms to be clean and odour free during our visit. Some of the home's practices however did not promote the good management of infection control and we identified that improvements were needed to fully protect people in this respect.
One person said 'the new buzzer system is a lot better ' staff respond more quickly'.