Background to this inspection
Updated
16 December 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 4 and 5 November 2015 and the first day was unannounced. The inspection was carried out by two adult social care inspectors, a specialist advisor who was a registered nurse and who had experience of caring for people living with dementia 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. In addition a specialist pharmacy advisor attended on the first day of the inspection.
Before the inspection we reviewed the information we held about the service such as notifications, complaint and safeguarding information. Prior to the inspection there had been a number of concerns raised particularly regarding medicines management and high levels of incident reporting. On 7 September 2015 the registered manager, the clinical service manager and the regional manager had met with local agencies and commissioners of services to discuss the concerns and to monitor progress with improvements. Feedback from the meeting held 16 October 2015 indicated the service was taking action to address any shortfalls and were taking action to improve.
The provider sent us a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information before the inspection visit.
We used a number of different methods to help us understand the experiences of people who used the service. During the inspection we spoke with thirty three people who used the service and with eleven family members. We talked with the registered manager, the clinical service manager, four unit managers, two nursing staff, seventeen care staff, the housekeeper and laundry staff, an activities person and the administrator. We also spoke briefly with the regional manager who was undertaking a monitoring visit on the first day of our inspection and with two visiting healthcare professionals.
We looked at a sample of records including seven people’s care plans and other associated documentation, three staff recruitment and induction records, training and supervision records, minutes from meetings, complaints and compliments records, medication records, policies and procedures and quality assurance systems.
Updated
16 December 2015
We carried out an inspection of Dove Court Residential and Nursing Home on the 4 and 5 November 2015. The first day of the inspection was unannounced.
Dove Court Residential and Nursing Home provides accommodation for people who need either nursing or personal care and support. Care and support is also provided for people who are living with a dementia. There are four units with 30 beds in each unit. Kingfisher House provides dementia nursing care, Robin House provides general nursing care, Swallow House provides dementia residential care and Nightingale House provides general residential care. Dove Court is situated in a residential area of Burnley, located on a main bus route and is close to many local amenities. Ample parking is provided for visitors. At the time of the inspection the service was providing support to 115 people.
At the previous inspection on 8 January 2014 we found the service was meeting all the standards assessed.
The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People felt safe and did not have any concerns about the way they were cared for. One person said, “I feel safe and that’s due to the people who are looking after me.” A visitor said, “I come often and I’ve never seen anything untoward.”
People made positive comments about the staff and the service they received. They said, “Staff are very good and very helpful” and “The staff are very good with people.” A visitor said, “Staff really show they care” and “I wouldn’t want mum in any other home. They are all so kind to mum and to me.”
Staff had an understanding of abuse and had received training about the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS). The MCA 2005 and DoLS provide legal safeguards for people who may be unable to make decisions about their care. We noted appropriate DoLS applications had been made to ensure people were safe and their best interests were considered.
Staff were recruited safely and were provided with a range of appropriate training and support to give them the necessary skills and knowledge to help them look after people properly.
Prior to the inspection visit there had been concerns about how people’s medicines were being managed. We found the medication system was regularly checked and audited with evidence prompt action had been taken in the event of any shortfalls. Improvements were ongoing.
Each person had a care plan that was personal to them and contained information about their likes and dislikes as well as their care and support needs. The care plans had been updated in line with any changing needs and people said they were involved in decisions about their care.
There were opportunities for involvement in a range of suitable activities. People said, “There is always something going on, we are never short of something to do.” Throughout the inspection we observed people involved in various discussions which generated lots of interest. We observed people getting much pleasure and enjoyment from talking to, stroking and feeding the house pets. People could visit the café or the on-site shop; staff provided a trolley service each week for those people who couldn’t access the shop. People also attended the on-site hairdressing salon where they could chat, read magazines and drink tea.
We observed people being offered alternatives to the menu and being offered their meals and snacks at a time that suited them. Most people told us they enjoyed the meals. They told us, “I can have something else if I don’t want what is on the menu”, The meals are bland and repetitive” and “The food is pretty good.” A visitor told us, “The meals always look very nice; there is fresh fruit available.” Information was available about people’s dietary preferences and any risks associated with their nutritional needs.
The home was safe and clean. Careful consideration had been given to ensuring the environment, furnishings and décor was suitable and safe for the people living there. People told us they were happy with their bedrooms.
Records showed staff had been provided with training to deal with emergencies such as fire evacuation and to ensure they were competent to use equipment safely and properly.
There was a stable and established management and staff team. We found there was a culture of openness and the managers and staff respected each other. People told us they felt Dove Court Residential and Nursing Home was well managed and that the registered manager and staff were approachable and open.
We found effective systems were in place to regularly assess and monitor the quality of the service. There was evidence these systems had identified shortfalls and that improvements had been made. There were effective systems to seek people’s views and opinions about the running of the home People were asked to complete an annual customer satisfaction survey to help monitor their satisfaction with the service provided. The results were analysed and then shared with people as part of a ‘You said, We Did’ process.