Archived: Dovecote Residential and Nursing Home

Updated 21 February 2020

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.

Inspection team

The inspection was carried out by two inspectors 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

Dovecote Residential and Nursing Care Home 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 unannounced.

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 and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and 11 relatives about their experience of the care provided. We spoke with 19 members of staff including the regional director, the regional manager, the registered manager, the clinical lead, nursing staff, senior care workers, care workers and activities, kitchen, laundry, administration and maintenance staff.

We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 21 February 2020

About the service

Dovecote Residential and Nursing Home is a care home providing personal and nursing care to 45 people aged 65 and over at the time of the inspection. The service can support up to 61 people across two floors. Nursing care was provided on each floor.

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

The provider had introduced an electronic care records system and archived people’s paper care plans. The new system did not permit staff to add more than one plan, subsequently information was missing from the records of people with more complex needs. Staff had received insufficient training and support to use the new records. This resulted in poor record keeping and people were placed at risk of receiving inappropriate treatment. During the inspection and after our site visits the management team provided reassurances actions would be taken to address the deficits. Work was started immediately to make improvements.

Recruitment of staff was safe. Staff underwent pre-employment checks before they began working in the service. Staff were supported through an induction and with supervision. Some staff needed to bring their training up to date.

The provider had systems in place to maintain people’s safety. Whilst regular fire and safety checks were carried out to ensure people lived in a safe building, there were some safety aspects of the service which needed to be addressed. The home was clean and tidy. Actions had been taken to make improvements to the bathrooms.

There were examples where people’s dignity was compromised. People told us staff acted in a kind and caring manner towards them. One person said, “All of the staff here are lovely - happy to help you and they have a joke as well, with you. They are kept very busy.” Relatives felt welcomed in the service.

Audits use to monitor the service had not found the areas of the service which required improvement.

Further work was required to develop people's communication plans so staff were able to make information accessible to people. We have made a recommendation about this.

People’s medicines were managed in a safe manner. Improvements had been made to the use of topical medicines.

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.

People told us they enjoyed the food. One person said, “I have no complaints with the food here it’s not bad at all.”

Staff worked with visiting healthcare professionals to promote people’s health and well-being.

Staff, people and relatives were complementary about the registered manager. Staff felt supported by them.

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 requires improvement (published 15 February 2019) The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, not enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We carried out this inspection earlier than planned. This was prompted in part due to concerns received about the number of safeguarding incidents and concerns about inaccurate records. A decision was made for us to inspect and examine those risks. We found evidence that the provider needs to make improvements. Please see the key question sections of this full report.

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

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.