Dorrington House (Watton)

Updated 20 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

This was a focused inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Dorrington House (Watton) is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Dorrington House (Watton) is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This 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. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was no registered manager in post.

Notice of inspection

This inspection was unannounced on the first day and announced on the second day. Inspection activity started on 25 August 2022 and ended on 8 September 2022. We visited the service on 25 and 31 August.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including notifications the provider must send us about significant events and incidents. We sought feedback from the local authority and healthcare professionals who work with the service. We used all this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with eight people who used the service and four relatives. We also spoke with the provider and 13 members of staff including the data manager, area support manager, team leaders, health care assistants, support workers and domestic staff. We received feedback from three healthcare professionals and from the local authority quality team.

We observed care and support being provided to people. We reviewed seven care plans and four medication records along with other records relating to the safety and quality of the service.

Updated 20 October 2022

About the service

Dorrington House (Watton) is a purpose-built care home providing personal care and support to up to 52 older people, some of whom were living with dementia. At the time of our inspection 41 people were using the service.

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

Feedback from people who used the service, their relatives and staff was positive about the changes made since the last inspection. Many felt the service was beginning to improve. A typical comment was, “It’s getting better, I think. There are a lot of changes going on, so we will have to see how they pan out.” Although this feedback was positive, we identified some areas which still required significant work to ensure people consistently received safe and high quality care.

Although staff numbers had increased, staff were not provided with all the training and support they needed to carry out their roles safely. Systems to monitor staff development were not robust and some new staff lacked skills and knowledge which placed people at potential risk of harm. We have made a recommendation regarding training for staff.

Although improved from our last inspection, records were not always accurate, and monitoring was not robust. We identified potential concerns with two people’s pressure care and one person who was at risk of dehydration, which the provider’s own monitoring systems had not identified. The provider plans to introduce a new electronic recording system to improve record keeping and ensure people’s health and welfare is safely monitored.

Medicines management had improved from our last inspection and the provider had purchased new safety equipment including pressure sensor mats and weighing scales. Safety systems such as the call bell system had been serviced. The provider had purchased new furniture to enhance the environment and enable more thorough cleaning. The service was clean but further deep cleaning was required in some bathrooms.

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 provider was open and honest in their response to our findings and promptly put actions in place. They demonstrated a commitment to work in partnership with other key stakeholders and keep CQC informed. A new manager has been appointed and the provider gave us assurances they will support them to continue to improve the service. Their appointment will enable the area support manager to return to their quality oversight role. We do not expect future inspections to be the method by which failings at the service are identified.

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 inadequate (published 8 June 2022) and there were breaches of three regulations. 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 the provider had made improvements but remained in breach of two regulations.

This service has been in Special Measures since 1 June 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulations 12 (safe care and treatment) and 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also checked whether the provider had followed their action plan relating to a breach of regulation 18 (staffing) and were now meeting legal requirements. Our focused inspection reviewed the key questions of Safe and Well-Led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for this service has changed to Requires Improvement. 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 Dorrington House (Watton) on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches of regulation in relation to the training and support of staff, assessing and monitoring the safety and quality of the service at this inspection.

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

Follow up

We will request an action plan from the provider to understand what they will do to further improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will meet with the provider and review this action plan and discuss how they will make changes to ensure they improve their rating to at least good. We will continue to monitor information we receive about the service, which will help inform when we next inspect.