The Care Quality Commission (CQC) has rated Dorandene - Care Home Learning Disabilities (known as Dorandene) in Reigate as inadequate and has placed it into special measures following an inspection in March.
CQC inspected the service in part due to concerns about staffing and infection control.
Dorandene can provide support and care for people who have a learning disability or autistic people. At the time of this inspection there were nine people at the service.
As well as the overall rating dropping from good to inadequate, so did the rating for how safe, responsive and well-led the service is. Their ratings for how effective and caring they are, have dropped from good to requires improvement.
The service has now been placed in special measures. This means CQC is closely monitoring it and will inspect again to assess whether improvements are made.
Rebecca Bauers, CQC’s director for people with a learning disability and autistic people, said:
“At the time of our inspection at Dorandene, the previous manager had left the organisation and a new manager had recently joined the service. We found that previous poor leadership had seriously undermined the culture at the service and the care provided.
“Inspectors found people weren't safe and saw several examples where people were at risk of avoidable harm and abuse. One person at risk of choking while eating wasn’t receiving support during mealtimes, and someone else had gone missing from the service last year but there was no record of this or how it could be prevented from happening again.
“We also found records showing another person hadn't seen a dentist for over three years and care records at the service didn’t show if other people were supported with oral hygiene.
"Poor leadership also had a detrimental effect on staff who appeared genuinely upset they couldn’t reduce risks and provide a better level of care. For example, some people were funded to receive significant one-to-one support but very few hours were provided as there wasn't enough staff on duty.
“Leaders at the service needed to do more to make this a better place to live for the people who called it home. When we arrived, we found a strong unpleasant odour downstairs, and the flooring and handrails weren’t clean and were tacky to touch.
“We also found there wasn't enough variety of food and drink, and the fridge and food cupboards weren’t well stocked. Staff were clearly upset about this and told us that they didn’t always have enough money in their budget to buy what they needed. One week they said they didn’t have enough in their budget to buy butter.
“Following the inspection, findings were reported to the provider and the new manager who are aware of what needs to be addressed. CQC will work closely with stakeholders and also continue to closely monitor this service and we’ll not hesitate to take further action if we’re not assured people are safe, or if improvements aren’t made.”
Inspectors found:
- People weren't always safe from the risk of abuse or neglect.
- Low staffing numbers were affecting staff’s ability to keep people safe
- The front door was not locked effectively
- Staff didn’t support people to be independent or treat them with dignity and respect and people and their loved ones told inspectors that when they had raised their concerns, they didn’t always receive a response
- Some fluid intake charts weren't completed correctly meaning staff didn’t know if people were drinking enough water
- Medicine stock checks were incorrect, and some medicines were stored in an unlocked fridge and cupboard in the kitchen which people using the service could have accessed
- There was no evidence of medication reviews, one person prescribed anti-psychotic medicines hadn't been reviewed for two years
- Staff understood they had a responsibility to protect people from abuse but were not clear on how to report concerns and accidents so didn’t always do this, which meant the service couldn’t learn when things went wrong to prevent it from happening again
- People hadn’t had the opportunity to personalise their bedrooms or chose the decoration. One person's bedroom wardrobe had a three-year-old record of their body temperature hanging on it.
However,
- People spoke positively about the staff, telling inspectors that staff were kind and caring and CQC observed kind interactions between staff and people.