Archived: Delph House Limited

Updated 21 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 11 and 16 May 2016 and was unannounced. Two inspectors and a specialist advisor attended on the first day of inspection. The specialist advisor was a registered nurse with expertise in the nursing care of adults. One inspector attended on the second day.

Before the inspection we reviewed the information we held about the home. We also liaised with the local authority and Clinical Commissioning Group (CCG) contract monitoring teams. Following our visit, we spoke with someone from the local authority safeguarding team.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Due to technical problems a PIR was not available and we took this into account when we inspected the service and made the judgements in this report.

We met most people living at the home and spoke or spent time with 6 people. Because some people were living with dementia we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We also spoke with three visiting relatives and with the two deputy matrons, the management consultant currently responsible for managing the home, six staff who provided people’s care, two other staff and a visiting health care professional.

We looked at seven people’s care and support records, six people’s medicines administration records and other documents about how the service was managed. These included four staffing records, audits, meeting minutes, maintenance records and quality assurance records.

Following the inspection, we received feedback from a further healthcare professional.

Updated 21 June 2016

This inspection took place on 11 and 16 May 2016 and was unannounced.

At our last inspection in October 2015 we found repeated breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to person-centred care, consent and acting in accordance with the Mental Capacity Act 2005, medicines management, meeting nutritional and hydration needs, and staffing levels. We also found new breaches in the legal requirements relating to dignity and respect, the assessment and management of risks, and the safety of the premises. The service was rated as ‘inadequate’ in relation to the questions: is the service safe, is the service effective and is it well led. We rated it as ‘requires improvement’ in relation to being caring and responsive. The overall rating for the service was ‘inadequate’ and the home remained in ‘special measures’. We had placed the home into special measures following the previous inspection in May 2015.

Following the inspection in October 2015 we considered the appropriate regulatory response to the shortfalls we found. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

At the inspection in May 2016, we found that improvements had been made to meet the relevant requirements and we have now removed the home from special measures. We found that the service had addressed all of the issues and that there were no breaches of regulations, although there were some areas for improvement. However, we were not able to assess whether the improvements made had been sustained. We will assess this further at our next inspection.

Delph House Limited is a care home with nursing in Broadstone near Poole in Dorset for up to 39 older people, some of whom may be living with dementia. At the time of the inspection 20 people were living at the home and 11 of these people were receiving nursing care.

The service is required to have 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 previous registered manager left the service in July 2015. They were replaced by a manager who subsequently left the service without being registered. A new manager started in post during the inspection and intended to apply to register as manager.

People’s individual care needs were met by staff who knew them well and were familiar with the care they needed for their safety and wellbeing. The home employed an activities coordinator and there was a range of activities for people. However, one person told us there was not always enough to keep them occupied and on a day the activities coordinator was not working, we observed someone in their room for several hours lacking stimulation. We have recommended that activities for individual people are reviewed to ensure that people all have the stimulation they need, particularly when they are in their rooms.

People’s privacy and dignity was maintained and staff were respectful and caring towards people. People could receive visitors whenever they wished.

There was a caring, open culture. People, relatives and staff were kept informed of developments at the home and were consulted regarding how the home was run. There were regular meetings for relatives and staff. Complaints were taken seriously and were investigated thoroughly. Staff felt well supported by the management team and knew how to blow the whistle if they were concerned about poor practice.

Records were accurate and up to date. Where people had particular nutrition and hydration needs, food and fluid intake was recorded, monitored and followed up so that any necessary action was taken.

Staff were supported in their roles through training and supervision. Morale was good and staff recognised that they had worked hard under the guidance of the current management team to bring about the changes that were needed.

A quality assurance system had been introduced. The management team audited and reported back on various aspects of the running of the home either weekly or monthly, with daily reports in relation to significant incidents. Learning from accidents, incidents, complaints and audits was shared with staff and was used to improve practice. Where actions had been identified, these were followed through.