Background to this inspection
Updated
1 April 2021
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 Care Act 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
The inspection was carried out by one inspector
Service and service type
Dexter Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was announced.
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be available to support the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We used observations to gather evidence of people’s experience of care. We spoke with three members of staff including the registered manager and support workers. We reviewed a range of records including one person’s care and medicines records. We looked at two staff files in relation to recruitment and a variety of records relating to the management of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found on inspection.
Updated
1 April 2021
About the service
Dexter Close is a residential care home providing accommodation and personal care for up to two people with learning disabilities. At the time of the inspection two people were living in the service.
People’s experience of using this service and what we found
People were not always protected from the risk of infection. The provider had not followed government guidelines to minimise the risk of infection from COVID-19. During the inspection we found staff did not always wear appropriate personal protective equipment (PPE) and there were no infection prevention and control policies in place to support staff knowledge.
The provider did not have robust systems in place to ensure they had oversight of the safety and quality of the service and staff had not always received relevant, up to date training to support them in their roles.
People were supported by a consistent staff team and there were enough staff on duty to meet people’s needs. Staff were safely recruited.
Staff told us they felt supported by the registered manager and were able to raise concerns. Relatives were involved in people’s care and were kept updated throughout the pandemic.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 11 January 2018)
Why we inspected
We had concerns in relation to infection prevention and control processes in the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the Safe and Well-Led sections of this report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dexter Close on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to infection prevention and control and the oversight of the service. 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 for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.