Denison House Care Home

We found the following examples of good practice.

Visits were facilitated in line with current guidance with screening and testing completed upon entry to the home. Visitors had access to appropriate Personal Protective Equipment (PPE).

An isolated vising pod could be utilised in the event of a COVID-19 outbreak. This ensured people could maintain contact with relatives. Staff supported people to use video calls and people also had access to the telephone.

All staff and people living at the service received regular COVID-19 testing. Appropriate processes were in place and followed should anyone display symptoms of COVID-19.

Staff wore PPE to minimise the risk of COVID-19 infection transmission. Training was provided which included donning and doffing PPE and infection control however this needed to be updated.

Audits were completed and used to ensure the service provided safe care and to identify improvement.

The provider had an up to date infection prevention and control policy.

Denison House is residential care home providing personal and nursing care to 27 people aged 65 and over at the time of the inspection; some of whom were living with dementia. The service can support up to 31 people.

Accommodation was provided over two floors; the majority were single rooms although couples could share if requested.

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

People, relatives and staff felt there were positive changes taking place and the registered manager was listening to their views and opinions. There was evidence of improvement around leadership, oversight and management within the service.

People felt safe and well looked after. All areas were clean, tidy and there was sufficient cleaning taking place to keep people safe from the risk of infection. Relatives said they were confident that staff provided good care in a safe way.

Care plans and risk assessments were in place for people's support needs. These had improved in quality since our last inspection and covered people's health conditions. Families confirmed that they were able to contribute their views on their relative’s care and support.

The assessment, monitoring and mitigation of risk towards people who used the service had improved. The registered manager carried out regular checks and analysis of falls and incidents to ensure learning from events was undertaken. This meant risks to people's health and safety were reduced.

People received their medicines on time and when they needed them. Improvements had been made to the recording of the application of topical medicines, such as external creams and ointments. Staff had positive links with healthcare professionals which promoted people’s wellbeing.

Staffing levels had improved and staff were patient, kind and respectful towards people. Care was more person-centred and staff had time to talk with people during the day.

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.

A registered manager had come into post since the last inspection. They were making positive changes to the service and people, staff and relatives spoke highly of them.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 10 September 2019) and there were two breaches of regulation.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 10 July 2019. Two breaches of legal requirement were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve quality assurance and cleanliness as part of their governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led, which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Denison House on our website at www.cqc.org.uk.

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.

Denison House is a care home providing personal and nursing care to people aged 65 and over, some of whom are living with dementia. At the time of our inspection the service supported 30 people; which is the maximum number of people they can accommodate.

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

On the first day of our inspection, there were issues with the cleanliness and safety of the environment. These were addressed between day one and two of our inspection. Staffing levels were safe, but staff worked in a task-orientated way due to how busy they were. People told us they felt safe and well cared for.

People’s care plans and risk assessments did not always clearly identify the support they required. People received their medicines but the recording around ‘as and when needed’ medicines and creams required further development.

The checks completed by the registered manager and provider had not identified areas which could affect the safety or the quality of the service.

Staff continued to be recruited safely. They understood the importance of sharing any safeguarding concerns and felt confident in doing so.

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. The documentation around people’s mental capacity required development.

Staff were kind, caring and patient in their approach with people. They took the time to listen to them and were familiar with their likes, preferences and personal histories.

Staff had good working relationships with health and social professionals and sought their advice when required.

People told us the food was excellent.

The environment had recently been refurbished and people now had access to a pleasant outdoor space. Consideration was being given to ways in which the environment could be more stimulating for people.

People had access to a variety of activities, which were arranged on a group or one to one basis. Church services were held in the service and people were supported to engage with their faith.

People and staff spoke positively about the registered manager. They were regarded as approachable and hands-on. A relative told us, “Denison House has been a lifesaver for me. All the staff are so welcoming and friendly. [The registered manager] is approachable and their door always open.”

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

Rating at last inspection

The last rating for this service was good (published 26 April 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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 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.